WEEKEND ONLINE TUTORING REGISTRATION - Daystar International Academy

Parent's Full Name *

First

Last

Parent's Email Address

Parent's Phone Number

Child's Full Name *

First

Last

Child's Age *

Grade / Class *

Preferred Class Time *

Morning sessions available only

Preferred Subjects (select all that apply) *

Internet Availability *

Device Availability (check all that apply) *

Please briefly describe any specific learning goals you have for your child in this program *

Are there any special considerations or accommodations we should be aware of? (e.g., learning disabilities, language preferences, etc.) *

Emergency Contact Information: *

How did you hear about us?

Referral Source (Optional)

Consent and Agreement *

I have read and understood the class schedule and expectations. I give permission for my child to participate in the online Saturday literacy and numeracy class.

Comments or Questions