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Home
Who We Are
How it Works
Express Interest
FAQ

Express Interest

At this time, we do not have any available openings in our pods. If you already have a pod that you need to match with a facilitator, please fill out the following intake form. Once you have completed it, our Pod Concierge will reach out to discuss next steps. Thank you for your interest!

For one-on-one tutoring, please fill out this form instead.

Intake Form

Parent/Caregiver Name*
First Last
Email Address*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
I would like to:*
- Register a Pod and be matched with a facilitator
There are no available openings in our pods at this time. Please complete this form if you have a pod to register and are looking to be matched with a facilitator.
Find a Pod for my child
How many children are you looking to register?*
Child 1
Child's Name*
First Last
Child's Date of Birth*
Month
Day
Year
Child's Grade*
Child's School District*
Child's School*
What date does/did your child's school start for the 2020-2021 school year?*
Month
Day
Year
Does your child have a diagnosis that may impact his/her learning and/or does your child receive any support services through the school district? Please explain.*
Child 2
Child's Name*
First Last
Child's Date of Birth*
Month
Day
Year
Child's Grade*
Child's School District*
Child's School*
What date does/did your child's school start for the 2020-2021 school year?*
Month
Day
Year
Does your child have a diagnosis that may impact his/her learning and/or does your child receive any support services through the school district? Please explain.*
Child 3
Child's Name*
First Last
Child's Date of Birth*
Month
Day
Year
Child's Grade*
Child's School District*
Child's School*
What date does/did your child's school start for the 2020-2021 school year?*
Month
Day
Year
Does your child have a diagnosis that may impact his/her learning and/or does your child receive any support services through the school district? Please explain.*
Child 4
Child's Name*
First Last
Child's Date of Birth*
Month
Day
Year
Child's Grade*
Child's School District*
Child's School*
What date does/did your child's school start for the 2020-2021 school year?*
Month
Day
Year
Does your child have a diagnosis that may impact his/her learning and/or does your child receive any support services through the school district? Please explain.*
Facilitation Information
Are you willing to host a Pod in your home?*
- Yes
- No
- Maybe
What days do you need facilitation (Check all that apply)*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
What hours do you need facilitation?*
- 8am - 1pm
- 9am - 2pm
- 10am - 3pm
Would you need aftercare for an additional cost?*
- Yes
- No
- Maybe
Please explain any safety practices your family has taken related to COVID-19 and describe your level of comfort with your child being around others during this time.*
Register a Pod
Your child's information
Child's Name*
First Last
Child's Date of Birth*
Month
Day
Year
Child's Grade*
Child's School District*
Child's School*
What date does/did your child's school start for the 2020-2021 school year?*
Month
Day
Year
Does your child have a diagnosis that may impact his/her learning and/or does your child receive any support services through the school district? Please explain.*
Other Children
How many other children are in this Pod?*
(excluding your child)
Child 1
Parent Name*
First Last
Parent Email*
Child Name*
First Last
Child Age*
Child 2
Parent Name*
First Last
Parent Email*
Child Name*
First Last
Child Age*
Child 3
Parent Name*
First Last
Parent Email*
Child Name*
First Last
Child Age*
Child 4
Parent Name*
First Last
Parent Email*
Child Name*
First Last
Child Age*
Facilitation Information
Are you willing to host a Pod in your home?*
- Yes
- No
- Maybe
What days do you need facilitation (Check all that apply)*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
What hours do you need facilitation?*
- 8am - 1pm
- 9am - 2pm
- 10am - 3pm
Would you need aftercare for an additional cost?*
- Yes
- No
- Maybe
Please explain any safety practices your family has taken related to COVID-19 and describe your level of comfort with your child being around others during this time.*
Please let us know which two COVID-19 precaution levels best describe your family's practices:
View this page to determine your risk group: Click here
- Risk Group 1
- Risk Group 2
- Risk Group 3
- Risk Group 4
Special Requests

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