Academic Support Inquiry

First name*

Last name*

Your email*

Phone number*

Student's current grade level*

Current grades*

Extracurricular activities*

Is the student on an IEP?*

yes

no

Is the student on a 504 plan?*

yes

no

Accommodations and Modifications*

What are the current concerns for your student? Check all that apply.*

Grades

Upcoming tests/final exams

SAT/ACT Test Prep

Homework Help

Learning Concerns

Suspicion of a learning disability

Focus/attention/organization

Teacher(s) expressed concerns

Study habits/executive functioning skills

Learning Concerns or Suspicion of Learning Disability*

If there are learning concerns or suspicion of a learning disability, have learning interventions been implemented for your student in school?*

yes

no

N/A

If so, please describe.*

Student's strengths*

Student's weaknesses*

What specific supports are you interested in for your student? Select all that apply.*

Online Tutoring (all subjects K-college level)

Online Test Prep (SAT, ACT, ASVAB, Private School Admissions, GED, etc.)

Ongoing Homework Help

Academic Coaching (to support executive functioning - study habits; time management; focus/attentiveness; organization)

College Admissions Planning & Consulting

Beyond the Diploma (career & life skills planning after high school)

Assistance in exploring possibility of a learning disabilty

Initial Consultation *

Questions*

Additional Information

Academic Tutoring

Academic Coaching

Test Prep

Educational Assessment

Special Education Consulting

& Advocacy

Beyond the Diploma

Educator Training & Support

Helpful Resources

Stay Connected

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Academic Support Inquiry

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