SOS4Students - Contact Us – Coaching (Discovery Call)

Contact Us – Coaching (Discovery Call)

Please complete this form to request services or ask questions about academic coaching.

After submitting the form, we'll ask you to schedule a 15-minute time slot for a call with our intake coordinator. It is not necessary for the students 17 and under to be part of this call. For students 18 and over, we would like students to conduct the calls themselves though they may have a parent present on the call as well.

By submitting this form you agree that SOS4Students may contact you via SMS for scheduling, reminders, and updates to any programs you have contacted us about or signed up for. For more information please email [email protected].

Parent

First Names (Parent 1 & Parent 2)

Last Name (Parent 1 & Parent 2 unless same)

Email (Parent 1)

Email (Parent 2)

Mobile Phone (Parent 1)

Interested In

Address

City

Address Line 2

State

Other Parent Information

Zip

Would you like your intake meeting to be via phone or Zoom? PhoneZoom

Student

First Name

Last Name

School

Grade (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, College)

Preferred Pronouns

I Need Help With (for parent)

Challenging Areas (check all applicable)

Student Buy In (to coaching)

Homework Load per Day

Weekly Coaching Availability (if applicable)

Extracurricular Activities

School Accommodations? (ie IEP, 504, learning planning) Yes

Evaluations? (e.g. School Testing, Neuropsychological Reports) Yes

External Services (Content Tutor, Counselor etc.)

Areas of Concern

Referred By

Remove

Add Fields for Additional Student