Please answer the following questions and send by WhatsApp to 0102 6351993 or email to info@pearlslearning.com. We will respond with the next two business days. We look forward to talking with you!
Name of Student _________________________________________________________
Age _____________ Grade _____________
School _____________________________________________________________________
Diagnosis (if any) _____________________________________________________________
Area(s) of help needed: ________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
Parent Information Name of Parent: _________________________________________________________
Phone Number: _________________________________________________________
Email address: __________________________________________________
Times your child would be available to have a lesson (indicate all possibilities)
Saturday 12:00 – 3:00 pm 3:00 – 7:00 pm
Sunday 10:00 am – 4:00 pm 4:00 – 7:00 pm
Monday 10:00 am – 4:00 pm 4:00 – 7:00 pm
Tuesday 10:00 am – 4:00 pm 4:00 – 7:00 pm
Wed. 10:00 am – 4:00 pm 4:00 – 7:00 pm
Thursday 10:00 am – 4:00 pm 4:00 – 7:00 pm
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