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* 1. Is your student participating in

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* 3. If not traditional learning

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* 4. Would you be able to afford a fee to have your student utilize a tutor at Austin17House for a few hours in the day?

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* 5. IF so, how much would be practical?

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* 6. Question, comments, concerns

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* 7. Please tell us the town where your student attends school along with the town you live in. (This will help us understand to plan for transportation needs)

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* 8. Please share  your contact information so we can reach out with the programs that Austin17House has to offer your family.

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