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Please provide us with some information about you and your child using the prompts below. We will review the questions and reach out to you and your child to see if this program will be the best fit for them.

Parent's Information

First Name

Last Name

Parent's Phone

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###

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Parent's Email

Parent's Address

Child's Information

First Name

Last Name

Date of Birth

What grade level is your child going into?

What group are you interested in signing your child up for?

Is your child enrolled in the ESA homeschooling program?

What is your child's interests or hobbies?

What are some of your child's strengths?

What are some of the areas you want to see your child improve?

Please share some goals that you have for your child this year?

Does your child have any previous schooling experience? Explain

Are their any medical or health conditions that we need to be aware of?

Anything else I should know about your child?

How did you hear about us?

I understand that this form does not guarantee us a spot and that we will be contacted directly to chat over the phone to see if we are a good fit.

I understand that this is not a "typical school" and that it will be listed as tutoring/teaching service on the invoice. I agree to release Mini Monsters Learning from all liability pertaining to my child.

I understand that I am welcome to come into the classroom at any point throughout the day or week to be with my child, help out, or just hang out and observe.

I understand this program will fill up fast and that if I am offered a spot, I must make my deposit payment within 3-5 days of approval to guarantee a spot.

I understand that Mini Monsters Learning does not tolerate bullying or disrespectful behavior towards other students and teachers and that such behavior is subject to removal from the program.

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