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2025-2026 Academic Year Interest Form
We are so glad you are here! Emily Remsen, LLC. is always looking for feedback and to meet the needs of individual learners. If you have any questions or concerns, please feel free to reach out via email. erremsen@gmail.com
Some questions may be answered on our website or Instagram page. Check them out at:
https://emilyremsen.com
@emily_remsen
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* Indicates required question
Email
*
Your email
Student Name (Last, First)
*
Your answer
Parent Name
*
Your answer
Parent Email
*
Your answer
Student Grade Level
*
Your answer
Area of Support Interested In
*
Choose
Executive Functioning Skills Support (1:1)
Executive Functioning Skills Support Bootcamp (Saturdays, starting 10/4)
Executive Functioning Skills Support Bootcamp Waitlist (Thursday evenings)
Orton-Gillingham Reading Intervention
Academic Support - In another subject
Other
What is your child's current reading level?
*
Your answer
What would you like to see your student grow in most this summer?
*
Your answer
What strengths or special interests does your student have?
*
Your answer
Any questions?
*
Your answer
Thank you!
Thank you for your interest! We are excited to be in touch soon! In the meantime, please feel free to reach out with any questions via email! erremsen@gmail.com
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