What is your child/children's name(s) ? [First and Last] *
Your answer
What grade is your child in? *
Do you have an email address? *
What is your email address?
Your answer
What is the best cell phone number to reach you at? *
Your answer
What are you most concerned about right now? *
Your answer
What is your biggest need right now? *
Does your child have an IEP or 504 Plan? *
If your child has an IEP or 504 Plan, what support do you need?
Your answer
Is your child's Chromebook working? *
Do you need to trade in your child's Chromebook for a better working device? [Please note - if you select YES, you will need to bring the current faulty device and a carrying bag to exchange for a new device at the Pelham Parkway Campus.] *
What else can the Icahn Community do to assist you at this time?
Your answer
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