Cascade Enrichment - Enrollment Form

Enrollment Form

Parent Information

First Name

Last Name

Mobile Phone

Address

City

State

Zip

Referral source

Student information

Student Information

First Name

Last Name

Pronouns:

Grade Level:

Birth Date

School

If your child has an email address and you would like them to receive their lesson notifications, please enter their email address here:

Child's Availability:

Child's General Availability:

More Detailed Availability:

Do you prefer in-person or remote tutoring?

Approximately how many hours per week of tutoring would you like?

Special Learning Considerations

Does your child have a physical or learning disability?

If your child has a learning disability please provide details here:

Study Areas

Select all areas you want us to focus on:

For high school students needing help with a specific class, please list the class(es) here:

Would you like your child's tutor to assign homework at the end of each session? This can help students continue to practice their skills and can be checked at the next tutor session.

Yes

Unsure

Add Fields for Additional Student