Intervention Coaching Interest Survey

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The success of any collaboration is predicated on the understanding of one's particular situation. In an effort to help support as many as possible, I'd like to collect vital information about your current circumstances and situation. I will then analyze the information and determine if I may be able to support you in your current role.

The completion of this form is not binding, and you are not obligated to join our group. It is simply a starting point.

Thank you so much!

Email *

Full Name

School and District (Please include city & state)

Your job title and role for the 2024-25 school year

Years of teaching experience. Please list grade levels and/or special programs.

Are you starting a new reading intervention at your site?

Yes

Other:

Clear selection

List all current assessments used for screening, placement, and progress monitoring of students.

Please provide a brief overview of your reading intervention program (grade levels, student population, program structure, support personnel).

What are your primary goals and objectives for seeking coaching services? Please elaborate on specific areas you wish to focus on.

What challenges or obstacles are you currently facing in your intervention efforts?

What coaching services are you most interested in? Check all that apply.

Private Coaching

Group coaching

School site or district partnership

A digital course that I can work through at my own pace

What is the best time to meet? *

During the work day

After work/evenings

Weekends

What time zone are you located? *

Pacific

Mountain

Central

Eastern

Other:

How did you hear about Emily Muccianti? *

YouTube

Social Media

Professional conference or training

I've taken one of her courses

Recommended by a friend/colleague

Other:

Is your school financially supporting this professional development? *

My school will cover my expenses.

I am covering my own cost.

I am planning to discuss this with them soon.

Other:

Click here to book a 15 minute discovery call so I can learn more about your situation.

Thank you for taking the time to complete this survey. I look forward to the possibility of working together to unlock the full potential of your reading intervention program and making a lasting impact on your students' literacy journey. Feel free to reach out to me any time - readingdiva06@gmail.com

A copy of your responses will be emailed to the address you provided.

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