Intake form

Help us serve you better

Name *

Email address *

Child's age

Preferred course level

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Beginner

Intermediate

Advanced

Syllables

Has your child attended any reading programs before?

What specific reading goals do you have for your child?

How did you hear about NextGenBrightMinds?

Preferred method of communication

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Phone Call

Text Message

Any additional comments or questions?

Additional questions or comments

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