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310-571-1176
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Continuation Form
Continuation.
Parent Name:
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Preferred Email:
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Preferred Phone Number:
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Student Name:
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Grade:
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School:
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First Day of School:
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We would like to resume services on (start date):
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We would like to continue with our current Academic Manager (if available).
We would like to request a new Academic Manager.
Comments or special requests:
Elementary School Students
Area(s) of specific need:
Middle/High School/College Students Schedule
English Subject
Math Subject
History Subject
Science Subject
Foreign Language Subject
Other Subject
I would like my child to receive Academic Management at:
Home
Franklin Learning Center
Other
Other (Please specify):
I would like my child to receive individualized Test Prep during his/her sessions:
ISEE
SSAT
SAT
Single-Subject SAT
ACT
Preferred Times
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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