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Individual Clients

Application - Step 1

SECTION 1 - CLIENT INFORMATION

Please take about 5 - 10 minutes to fill our this form so that we can learn more about your & your student(s)

1.) Contact Information

SECTION 2 - CURRENT ACADEMIC STATUS

Please take about 5 - 10 minutes to fill our this form so that we can learn more about your & your student(s)

1.) Student Information

The following statements focus on the students previous grade level. Please rate your level of agreement with each item.

The student had difficulty with this subject in previous grades.

Agree

Somewhat agree

Disagree

N/A

The student is motivated to improve their grades/knowledge.

Agree

Somewhat agree

Disagree

N/A

The student pays attenton in class.

Agree

Somewhat agree

Disagree

N/A

The student has behavioral issues.

Agree

Somewhat agree

Disagree

N/A

The student completes their homework assignments on time.

Agree

Somewhat agree

Disagree

N/A

Did the student have tutoring in the past?

Yes

Did the student have tutoring in the past?

Yes

Disagree

If the student has had tutoring in the past please explain how tutoring helped/did not help the student. (If the student did not have tutoring, type N/A.)

If the student has an IEP or learning disability. Explain. (If the student has no IEP or learning disability, type N/A.)

Do you have any concerns about the student that we should know about?

Does the student attend after-school activities? What obligatios do they?

Does the student attend school extra help?

SECTION 3 - WORKING WITH US

In this section, we will ask you about what your current academic goals and needs are.

What are you looking forward to most with the student working with Solomon Tutoring?

What improvement would you like to see in the student's academics. What goals would you like assistance to meet.

Please explain what challenges the student is facing and what actions were done in the past to help them.

What would you like us to focus on first? Choose three areas. (Our holistic tutoring approach will help improve all of these areas eventually by prioritization, targeted practice, and consistent tutoring)

What type of feedback would be helpful to receive about the student's lessons with Solomon Tutoring?

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