Parent Questionaire | Rational Rhythms

Name

Email

Phone

Student's Name & Grade

Session Preferences

Virtual

In Person

Frequency

Weekly

Twice a week

Custom

Select all that apply

Homework Help

Weekly Enrichment

Test Prep

What day(s) and time(s) are you interested in? * Please choose a day and time that is consistent weekly. Days and times may be altered based on availability. Preferences are met on a first come, first serve basis.

Please provide any information about your scholar and/or the content they are learning.

If a syllabus or scope and sequence was provided, feel free to attach it below.

Payment Preferences

Weekly

Monthly

Terms & Conditions: Please review in link below first.

I agree to the terms and conditions.

Terms & Conditions

Media Consent: I consent to photos or videos to be taken and used solely for social media and website posting/testimonials. See examples on IG: @rationalrhythmslearning

I do!

I DO NOT.

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