Academic Mentorship Inquiry form Consultant/Parent Name * First and Last Name Consultant/Parent Email * Company Name Student Name * Include preferred English name if available First Name Last Name Student Email * A non-school email is preferred Student Grade * G2 G3 G4 G5 G6 G7 G8 G9 G10 G11 G12 Student School * Subject Area * English | History (includes World History, US History, European History) | Social Science (includes Economics and Psychology) | Math | Science| World Languages | Other Subject Level, Specifics and Course Materials (i.e., Honors, Advanced, AP, course description if available) * Specific Learning Objectives: What does the student want to accomplish from the sessions? For example: extra help for school courses; preview lessons; etc. * What does the student want to cover in the first session? Please list the topics/concepts. * Start Date * We require 3-5 business days to process your inquiry MM DD YYYY How many sessions per week? * How long for each session in hours? * 1, 1.5, 2 hours Total hours needed? * Minimum of 5 hours required Student's Availability * Best time of the day and days of the week in EASTERN TIME ZONE Thank you for your inquiry. We will be in touch shortly. We look forward to working with your student.
