Tutoring In-Take Form

This form is for parents or guardians who are interested in enrolling their elementary-aged children in WGI's literacy tutoring program. By completing this form, parents can provide essential information about their child's literacy skills, specific needs, availability, and goals. WGI will use the information provided to tailor a personalized tutoring plan to address each child's individual learning requirements and support their literacy development journey.

Please complete the form below

Parent/Guardian Information

First Name

Last Name

Phone

(###)

###

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Preferred Contact Method

Student Information

First Name

Last Name

Age

Grade Level

Does the child have any diagnosed learning disabilities or special needs? (If yes, please specify)

Literacy Assessment

How would you rate your child's current reading ability?

How would you rate your child's current writing ability?

What specific literacy skills or areas do you feel your child needs assistance with?

Do you have any recent test scores, report cards, or other documents that could help us gauge your child's current performance in literacy-related subjects?

Which days and times are most convenient for tutoring sessions? (Please provide multiple options)

What goals do you have for your child's literacy development?

Is there any other information you would like to share about your child's learning needs or preferences?

Thank you for completing our intake form! A dedicated WGI Learning Ambassador will reach out to you shortly to schedule an introductory Zoom or call. During this meeting, your Ambassador will introduce the tailored tutoring plan for your child based on the information provided in this form. We look forward to working with you to support your child's literacy journey!

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Tutoring In-Take Form

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