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The Absorbent Mind
Thank you for your interest in
The Absorbent Mind
. Please fill out this information so that we can best support your child's needs.
1.
Parent/Guardian first and last name:
2.
Parent/Guardian email address & phone number:
3.
Child's first & last name, and date of birth:
4.
Child's current grade level (during summer, use rising grade):
5.
Name of child's school or indicate if homeschooled:
6.
What area(s) does your child need academic support in?
Math
Language
Both; Math & Language
7.
How can we help support your child's existing IEP or 504?
8.
Do you have your child's most recent MAP and/or DIBBLES scores?
Yes
No
9.
What top 3 goals would you like your child to achieve through the use of these services?