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Family Interest Form

This Registration Form Template allows you to collect registrations in a clear and structured way for events, programs, or online access.

The template includes common registration form fields such as name, email address, professional information, and can be easily customized to fit different registration flows.

This free registration form template helps you manage signups efficiently and reduce manual follow up.

Let's start with your personal details

Parent/guardian full name

Child’s first name

Child’s age and grade

What neighborhood do you live in?

What school does your child attend?

What subjects does your child need support in?

What subjects does your child need support in?

Briefly describe what your child needs help with.

Is your child currently behind, on grade level, or seeking enrichment/advancement?

Is your child currently behind, on grade level, or seeking enrichment/advancement?
A
B
C

Can your child commit to two 1.5-hour sessions per week?

Can your child commit to two 1.5-hour sessions per week?
A
B

Preferred tutoring location:

What days/times usually work best?

Are you able to contribute $5/week or $20/month?

Are you able to contribute $5/week or $20/month?
A
B

Does your child have any learning needs, language needs, or accommodations we should know about?

Optional: child/family race or ethnicity

Optional: household size

Optional: approximate household income range

I understand this is an interest form and not a guarantee of acceptance.

I understand this is an interest form and not a guarantee of acceptance.
A

Anything else you want us to know?