Intake Form

I look forward to learning more about your child(ren) and working with your family! This form will provide me with initial information about your child(ren)’s age, grade, interests, social/emotional needs, behaviour and learning strategies, preferred curriculum focus and any additional information that you feel is important I know before we get in contact and work together. If you have any questions about the intake form, please contact me at meganmcguirelearning@gmail.com.

Child 1

Child's Name

First Name

Last Name

Child's Birthdate

YYYY

Child's Grade (2024/2025 School Year)

Child's School/School Board

What are your child's interests?

What are your child's current social/emotional needs?

What behaviour and learning strategies are most successful for your child?

What areas of learning does your child need extra support with?

What are your child's favourite areas of learning?

Please use this space to highlight any additional information about your child.

Child 2 (Optional)

Please complete if you have a second child who will be participating in the classes.

Child's Name

First Name

Last Name

Child's Birthdate

YYYY

Child's Grade (2024/2025 School Year)

Child's School/School Board

What are your child's interests?

What are your child's current social/emotional needs?

What behaviour and learning strategies are most successful for your child?

What areas of learning does your child need extra support with?

What are your child's favourite areas of learning?

Please use this space to highlight any additional information about your child.

Parent/Guardian 1

Name

First Name

Last Name

Phone

(###)

###

####

Parent/Guardian 2 (Optional)

Name

First Name

Last Name

Phone

(###)

###

####

How did you hear about Megan McGuire Learning?