Student Intake Form

Student Tutoring Intake Form

Please complete one form per child. Type into the fields or print and write your answers. This intake begins a conversation; it does not confirm enrollment or require payment.

Family Information and Scheduling

Parent/Guardian Full Name

Email Address

Phone Number

Student's Full Name

Date of Birth

Current Grade

Current School

Scheduling and Learning Needs

When would you like your child to begin tutoring?

Which days are you interested in?
MondayTuesdayWednesdayThursdayFridaySaturday

What times generally work best?

Preferred Format
[radio* preferred-format default:1 "In-Person" "Online" "Hybrid"]

What prompted you to seek additional academic support for your child?

Which areas would you like support with?
ReadingMathWritingScienceTest PreparationExecutive FunctioningOther

What are your biggest academic concerns right now?

Learning Profile and Academic Records

What would you most like your child to accomplish through tutoring?

Has your child's teacher identified any concerns or recommended additional support?

What would you consider your child's academic strengths?

Is there anything about how your child learns, communicates, focuses, or responds to instruction that would be helpful for us to know?

Is there anything else you would like us to know about your child or your family's goals?

Upload Academic Records (if applicable)

+ 1 (469) 584 4926
info@handsfree-academy.com
3951 Alma Rd, Unit 301, McKinney, Texas

About Us

At Hands Free Learning, we create an environment where children can receive the support they need, be challenged at the right level, build confidence, and rediscover the joy of learning.

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