Remote Learning Studio Application
Fall 2020
6 Old Rochester Road, Suite #101, Dover, NH 03820
Contact: (603) 674-1170 or jmacneil@nowweretalkingusa.com
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Email *
Student's Full Name *
Student's Preferred Name *
School Attended During 2019-2020 School Year *
Grade During 2020-2021 School Year *
Parent / Guardian Name *
Best Phone Number: *
Parent / Guardian Email *
Address *
Please describe your student's academic strengths. *
Please describe your student's academic needs. *
Are there specific areas in which you would like your student to receive support? Please check all that apply. *
Required
Please describe how you view your student as a learner. *
Please describe how your student views themself as a learner. *
What level of support does your child require to complete written schoolwork? *
Required
What level of support does your child require to complete grade-level math assignments? *
Required
What level of support does your child require to complete grade-level reading assignments? *
Required
Program Design: At this time, please check the box that best describes the type of program you are looking for. *
Required
Interview: As part of the application process an interview is required. At the interview, students will be asked to read a short passage, respond to written questions, and draft up to one paragraph of writing. This is a low-stress activity designed to help the instructors plan and effectively meet the needs of your student. Additionally, we will discuss the studio, what to expect, and answer any questions you may have. Interviews last about an hour. Please select all interview timeframes that would work for your family. *
Required
This is your opportunity to tell us anything you would like us to know about your student, ask questions, share your thoughts, concerns, or ideas.
What day(s) would you like your student to attend? Please check all that apply. *
Required
How many sessions per week are you interested in? *
I understand that studio time is reserved on a monthly basis. Studio time must be reserved and paid for seven days prior to the start of the month. *
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