Student Information
Please fill this out to help me get to know you and your child better. I am looking forward to an awesome year and excited to be partnering with you to support your child's learning this year!
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Email *
Student Name *
Nickname
Student Birthdate *
MM
/
DD
/
YYYY
Home Address *
Medical Concerns (Allergies, Asthma, etc.) *
What do you see as your child's academic strengths?
Are there any areas you hope to see your child grow in this year?  
Other Specific Concerns or Information You Would Like to Share With Me *
Please list one thing you and your child are most looking forward to this year. :) *
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