Tutoring Intake Form
Thank you for your interest in tutoring with iGen's Educational Academy.  Please answer all questions to the best of your ability.  It will help us gain an understanding of your iGener and how to better service him/her.
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Email *
iGener's Information
Name *
E-mail
Name of School *
Current Grade *
Parent/Guardian Information
Name *
Relationship *
Phone Number *
Academic Background
Is your iGener receiving any accommodations at school? *
Is your iGener on grade level? *
How would you rate your iGener's... *
Poor
Fair
Good
Excellent
School Grades
School Attendance
Attitude Towards School
School Conduct
My iGener would benefit from tutoring in English Language Arts. The skills I would like to focus on are (check all that apply): *
Required
My iGener would benefit from tutoring in the following math courses (check all that apply):
My iGener would benefit from tutoring in the following science courses (check all that apply):
I would like tutoring to take place: *
Required
What is/are the reason(s) you would like your child to receive tutoring? *
I would like tutoring to start on: *
MM
/
DD
/
YYYY
My iGener is available for tutoring during the: *
Required
I would like tutoring to take place: *
Required
Is there any other information you'd like iGen Educational Academy to know about your iGener's learning style, abilities, areas of growth, etc.?
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