CAL Prep Learning Center

* Indicates a required question

Email *

Section 1

Student Information

Student Full NameStudent Date of Birth *Current Grade Level *Student School Name *

Section 2

Parent/Guardian Information

Parent/Guardian Name *Parent Email Address *Parent Phone Number *

Preferred Method of Contact *

Phone Call Text Message Email

Section 3

Academic Information

How would you describe your student's current academic performance? *

What are your primary academic concerns for your student? *

Section 4

Educational Goals

What would success look like for your student after working with CalPrep? *

Section 5

Learning Profile

Does your student currently receive any accommodations at school? *

Yes No Unsure

If yes, please describe any accommodations. *

Section 6

Program Interest

Which program are you most interested in? *

Is your student currently homeschooled? *

Yes No Considering Homeschooling

Are you interested in academic acceleration opportunities? *

Yes No Not Sure

Section 7

Consultation Information

When would you like to begin? *Is there anything else you would like us to know about your student before our consultation? *Parent Acknowledgment *I understand that submitting this form does not guarantee enrollment and that all students begin with a consultation and academic assessment.

Your information is used only to evaluate program options and prepare for your consultation.