Your Name (Parent / Guardian)
Current Grade Level
In what subject(s) does your child need help?
Why do YOU believe your child is struggling?
What are your expectations for tutoring?
What is your child's learning style?
Does your child have a learning difference (disability)?
Is your child currently taking any medication(s)?
What is your child's personality type/interests?
Preferred Location of Tutoring
Tutoring hours per week requested
Desired Start Date
Is there anything else you think we should know about your child?
How did you hear about us?
THANKS for your interest in MindWorks! Please fill out the following information about your child to ensure that we best meet their needs.