Summer 2017 Registration Form

STUDENT INFORMATION

First Name
Middle Name
Last Name

Age
Date of Birth

School
Grade

Regular MedicationsDietary Restrictions

Student Email

Student Cell

Areas of Focus for Educational Coaching

Other Collaborating Professionals

PARENT/GUARDIAN INFORMATION

Prefix
Name

Relationship to Student

Email Address

Address

City
State
Zipcode

Employer/Occupation

Home Phone
Cell Phone
Work Phone

Preferred Method of contact

Signature [signature* signature-814]

Search

Search for:

About Us

The Family & Learning Center provides a unique type of tutorial intervention called Educational Coaching. All of our sessions are one-on-one and focus on teaching the student how to learn.

Social Media

Follow us on social media for updates and more!

Current Hours

Monday 8am - 8pm
Tuesday 8am - 8pm
Wednesday 8am - 8pm
Thursday 8am - 8pm
Friday (appt only)
Saturday (appt only)
Sunday (appt only)

Contact Info

Want to schedule a consultation? We’re here to help! We welcome your calls/emails and invite you to visit our office with an appointment.

7433 Herschel Ave. Suite 2
La Jolla, CA 92037
(858) 454-7303
[email protected]

About
Academic Year 2016/2017 Registration Form
AY 16-17 Registration Form
Careers
Contact
Educational Resources
FAQ
Free ADHD Assessment
Free Dyslexia Assessment
Free Educational Coaching Consultation
Get Started
Home
Learning Programs and Services
Our Team
Raving Reviews
Registration Form
Summer 2017 Registration Form