Student Information Form

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To ensure I provide the best personalized tutoring experience for your child, please take a moment to fill out this student information form. Your responses will help me understand your child's unique learning needs, preferences, and goals. If you have any questions or additional information you'd like to share, feel free to include them in the form. Thank you for your time and cooperation – I look forward to working with you and your child to support their educational journey. This form will be filled out one time and does not need to be completed again if you book multiple sessions.

Student Name (First and Last) *

Student Age *

Student Grade *

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Fifth Grade

Middle School or Higher

Parent/Guardian Name (First and Last) *

Parent/Guardian Email *

Student Strengths *

Areas of Concern *

Math

Reading/Language

Writing

Required

Specific details regarding areas of concern - This will help me know what your child needs to work on. Please be as specific as possible. *

Learning Style *

Visual Learners: These learners prefer to see and observe things, such as pictures, diagrams, written directions, and graphic organizers. They often benefit from color-coding, visual aids, and spatial awareness activities.

Auditory Learners: These learners learn best through listening. They might prefer lectures, discussions, podcasts, and audiobooks. They benefit from verbal instructions and may excel in oral presentations.

Kinesthetic Learners: These learners prefer a hands-on approach and learn best through physical activities and movement. They enjoy doing experiments, building models, and engaging in tactile learning experiences.

Reading/Writing Learners: These learners absorb information best through reading and writing activities. They benefit from making lists, reading textbooks, and taking extensive notes.

Logical/Mathematical Learners: These learners excel at reasoning, recognizing patterns, and solving problems logically. They enjoy working with numbers, conducting experiments, and using step-by-step reasoning.

Social (Interpersonal) Learners: These learners prefer learning in group settings. They thrive in collaborative environments, discussions, and activities that involve interacting with others.

Solitary (Intrapersonal) Learners: These learners prefer to work alone and are often self-motivated. They benefit from self-paced learning, reflection, and personal goal-setting.

Any relevant medical or learning conditions. Ex: IEP, Dyslexia, etc. *

Additional information that might be helpful for me

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