Learning POD Intake Form
Greetings, Coach Matthew & Jenn, owner-operators of JMG INC here! We have been coaching/tutoring kids for over 10 years. Our coaches use a GROWTH MINDSET and have backgrounds in Early Childhood Development, Psychology, Education. And they are high-level athletes (Pro, semi-pro, club).

We can be with your kids during online classes or after school to promote comprehension, engagement and help with homework! In between, your kids play, create, exercise, and socialize all in a safe environment!
JMG is fully insured, vetted, and can work at parks or your backyard. JMG provides flexible scheduling and pricing with a variety of different sports, academics, languages, and creative arts activities!

In order not to widen the education gap we are honoring our scholarships for those qualified for the National Reduced Lunch Program.

Please fill out the following so we may create the best pod experience for your kid(s).

AS YOU MAY HAVE REALIZED CREATING PODS THAT ACCOMMODATE EVERYONE's UNIQUE SITUATIONS CAN BE  OVERWHELMING. WE ARE HERE TO ASSIST.

PLEASE SHARE FORM W/ ALL YOUR FRIENDS/FAMILY & HAVE YOUR TEACHERS SEND OUT TO THEIR CLASSROOM PARENTS SO WE CAN CREATE THE MOST EFFECTIVE LEARNING EXPERIENCE FOR YOUR KIDS!
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Parent's Name *
Email *
Mobile Number *
2nd Parent's Name
Email
Mobile Number
Child's Name, School and Grade *
Other children's info (Name, School and Grade)
Online or In-Person *
Number of days of the week *
Start Date Preferred *
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Start Time *
Time
:
End Time *
Time
:
Academic Preferences outside of your teachers' curriculum
Enrichment preferences *
Required
Special Needs? (Please specify)
Do you have a location/space? (Park, Backyard, Open Porch, describe the size) *
Do you qualify for the National Lunch Program *
Other Pod Participants (Parent's name, email, contact #, Child's name, age, and grade)
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