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Intake form
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Name
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Email address
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What age group does the student belong to?
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3-5 years
6-8 years
9-12 years
13-15 years
16-18 years
What type of learning environment are you interested in?
Please select at least one option.
Microschool
Homeschool
Hybrid
Does the student have any specific needs or requirements?
Please select at least one option.
Neurodivergent
Special needs
Gifted
None
What subjects are you most interested in for your student?
Please select at least one option.
Gardening
Animal Care
Cooking
Outdoor Exploration
Core Academics
How did you hear about nova roots academy?
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Social Media
Friend or Family
Online Search
Event
What is your preferred method of communication?
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Email
Phone
In-Person
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Additional questions or comments
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