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Tailored-Tutoring Intake Form
Complete the form form below to schedule an intake session.
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* Indicates required question
Parent First Name
*
Your answer
Parent Last Name
*
Your answer
Parent Mobile Phone
*
Your answer
Parent Email
*
Your answer
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Grade
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Freshman
Sophomore
Junior
Senior
Other:
Requested Tutoring Subject
*
Math
Science
Reading
Writing
Spanish
Social/Emotional
Other:
Has your student taken the knowandlove.com quiz?
*
Yes
No
If so, which animal is your student? Or Myers Briggs Type Indicator (MBTI)
Beaver (ISTJ/ISFJ)
Meerkat (INFP/ISFP)
Panda (INFJ/INTJ)
Owl (INTP/ISTP)
Parrot (ENFP/ENTP)
Elephant (ESFJ/ENFJ)
Border Collie (ESTJ/ENTJ)
Otter (ESFP/ESTP)
Clear selection
Which day(s) works best for an intake session?
*
Friday
Saturday
Sunday
Monday
Tuesday
Thursday
Required
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