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Academy Interest Intake Application

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1
What is your first name?
This question is required
Invalid Entry : Please Enter Only Alphanumeric
2
What is your last name?
You must enter a last name on your application
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3
On a scale of 1 to 10, how successful do you think your child is at learning on their own for 30-45 minutes?
0 - Not at all likely 10 - Highly likely
  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
Not at all likely Highly likely
This question is required
Not a valid answer
5
Which instructional method do you think your student would most prefer?
  • A (Live) Instructor Lead
  • B Recorded (Computerized Based Training)
  • C Co-Hort with teams
  • D Self Paced
  • E Other
This question is required
Not a valid answer
6
What life skills do you most share with your student now?
  • A How to pay bills
  • B How to count change
  • C How to communicate effectively
  • D How to cook
  • E How to clean
This question is required
Not a valid answer
7
How technical or familiar is your student with basic online software programs like email or web browsers?
  • 1
  • 2
  • 3
  • 4
  • 5
Not at All Very Good
This question is required
Not a valid answer
8
Where should we send the notifications?
Please Enter Email Address (check spam or junk mail)
This question is required
Please enter valid email address
8
What is the age range of your student?
  • A 7-9 yrs old
  • B 10-13 yrs old
  • C 14-16 yrs old
  • D 17-19 yrs old
  • E 20-22 yrs old
This question is required
Not a valid answer
9
Are you a parent or guardian for the prospective student?
  • A Yes
  • B No
This question is required
Not a valid answer
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