Parent & Student Questionnaire

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Student & Parent Questionnaire

“Students don’t know what they don’t know until they learn.”

Email: stevenadel905@aol.com Phone: 678‑779‑0288

STUDENT INFORMATION

Student Name

Age

Grade

School

Student Phone

Student Email

Parent/Guardian Name(s)

Parent Phone

Parent Email

ACADEMIC BACKGROUND

Current GPA

Strongest Subjects

Subjects You Struggle With

Learning Accommodations (IEP, 504, tutoring, etc.)

Biggest Academic Challenge Right Now

INTERESTS & PASSIONS

Activities, Hobbies, or Sports You Enjoy

Something You’re Good At That Most People Don’t Know

Something You Want to Learn But Haven’t Tried Yet

GOALS & ASPIRATIONS

What Do You Want to Accomplish This Year?

Career or Future Path That Interests You

What Does “Success” Mean to You?

One Habit You Want to Improve

LEARNING STYLE & STRENGTHS

How Do You Learn Best?

What Helps You Stay Focused?

What Distracts You the Most?

Your Greatest Personal Strength

CHARACTER & LEADERSHIP

Describe Yourself in Three Words

Have You Ever Led a Team, Group, or Project?

What Do You Do When Things Get Difficult?

Someone You Admire & Why

SUPPORT & WELL‑BEING

What Stresses You Out the Most?

How Do You Handle Pressure?

What Excites You About Joining Advantages Academy?

What Do You Want Coach Stephen to Know About You?

PARENT/GUARDIAN SECTION

Parent/Guardian Name(s)

Best Contact Method

Your Child’s Greatest Strengths

Areas Where Your Child Needs the Most Support

Concerns About Academic, Social, or Emotional Development

What You Hope Your Child Gains From Advantages Academy

How You Heard About Advantages Academy

Family Expectations & Partnership

Expectations You Have for Coach Stephen

Expectations You Have for Your Child During This Program

Family Circumstances or Challenges We Should Be Aware Of

Preferred Communication Style

SIGNATURES

Student Signature:

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Parent/Guardian Signature:

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Date

Month

Day

Year