This college planning discussion group will take place on the second Wednesday of the month, January through June 2023. Parent Name * First Name Last Name Email * Phone * Student Name * First Name Last Name Email * Phone * Class Year * Sophomore Junior Current school * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Please check ALL days of the week when your students is available for a meeting. * Meetings will take place once a month January through May. They will take place at 5pm ET on the same weekday each month, based on your availability. Monday Tuesday Wednesday Thursday What do you hope that your child will gain from working with me? * Do they have any learning differences or mental health challenges that I should be aware of? When working with the student, I will not bring up any information provided here. Anything else you would like me to know about your family and/or student? Thank you!