Main Student Intake Form

This form takes 20 minutes or more to complete. Please take your time as this information is critical in designing an optimal learning plan.

"*" indicates required fields

Step 1 of 5 - Contact Information

This field is for validation purposes and should be left unchanged.

Parent Full Name*

First Last

This field is hidden when viewing the form

Parent's Full Name

Parent's Primary Phone*

Parent's Primary Email*

Would you like to add a secondary contact?*

Yes

This field is hidden when viewing the form

Secondary Contact's Full Name

Second Contact Full Name

First Last

Secondary Contact's Phone

Secondary Contact's Email

Student's Full Name*

First Last

Student's Phone*

Student's Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

This field is hidden when viewing the form

Does student have a medical condition or serious allergy?

For example: epilepsy, allergies to nuts or dairy etc. This information is important so we can ensure a safe learning environment.

Yes

High School

High School Graduation Year*

Student's Weighted GPA*

This field is hidden when viewing the form

Is your child equally strong in math, reading, and writing?

This field is hidden when viewing the form

Not including assigned reading for school, how many hours per week does your child read?

We understand that reading hours can change during the school year vs during the summer. Please provide your best estimate. We find this answer helpful when we use it in conjunction with a baseline reading score.

0-1

1-2

2-3

This field is hidden when viewing the form

How many hours per day does your child typically study?

If you are answering this question during the summer, please provide an estimate based on the school year.

0-1

1-2

2-3

Please list your child's current (or most recent) classes and grades.*

Please add one class per line. You can use the return key to move to the next line.

When your child earns a good grade (like an A or B), does that usually reflect strong test and quiz performance?*

Yes — test scores and grades usually match

Not always — grades are good, but tests can be a struggle

No — my child often gets good grades despite weak test performance

I’m not sure

Does your child have a diagnosed learning difficulty?*

Yes

Considering having him or her tested

Does your child have an IEP or 504 plan?*

Yes

Has your child been approved by ACT for accommodations?*

Yes

We have applied but have not heard back.

Has your child been approved by COLLEGE BOARD for accommodations on the SAT?*

Yes

We have applied but have not heard back.

How would you rate your child's current stress level?*

High

Moderate

Low

What have you noticed about how your child performs under time pressure (like during tests or quizzes)?*

Stays calm and often outperforms

Gets nervous but performs as expected

Becomes really anxious and often underperforms

This field is hidden when viewing the form

Can you share any ways to help reduce your child's anxiety?

How does your child typically respond to significant challenges, especially in school?*

Avoids the challenge

Does whatever it takes to succeed

Hasn't had much difficulty

This field is hidden when viewing the form

Has your child taken an official SAT?

Yes

No, but he/she took a baseline at Hammer Prep

This field is hidden when viewing the form

Please list all previous SAT scores.

This field is hidden when viewing the form

Has your child taken an official ACT?

Yes

No, but he/she took a baseline at Hammer Prep

This field is hidden when viewing the form

Please provide all previous ACT test scores.

The schools that most interest my child are:*

We find that some students struggle to answer this question and that's okay. If that's the case, just do your best to let us know the category of school that interests you. We don't want you to hold back in answering this question. We want to know where you're aiming.

Most Selective | 34+ ACT or 1500+ SAT| Admit rate below 10% | Harvard, Stanford, MIT

Extremely Selective | 30+ ACT or 1400+ SAT | Admit rate below 25% | Boston College, Colgate, Notre Dame

Selective | ACT 27+ or SAT 1300+ | Admit rate below 40% | SDSU, Bucknell, Villanova

Moderately Selective | ACT 24+ or SAT 1100+ | Admit rate below 75% | High Point, Drake, Texas Tech

Popular | ACT 22+ or SAT 1000+ | Admit rate above 90% | University of Oregon, Utah State, Arizona State

Not sure yet. We need to do some research.

How much of a point increase is your child working toward?*

We find that aiming for a specific target can be helpful, but it doesn't make or break a test prep program. It we know your goal, we can provide you more precise information about how much effort it will take to get there. Answering NOT SURE if perfectly okay.

+2 or more ACT or +80 SAT

+4 or more ACT or +150 SAT

+6 or more ACT or +250 SAT

Not sure

Approximately, how many hours per week is your child willing/able to invest to raise his/her test scores?*

We find this answer very helpful in understanding how serious a student is about improving. A consistent training schedule with solid effort over several months will result in considerable improvement. Before selecting your answer, it may be helpful to know that there are 168 hours in a week.

Which of the following best describes your weekday afternoons and evenings?*

(Select all that apply)

We’re usually at home by 4pm and prefer to stay in.

We frequently have sports, extracurriculars, or other evening commitments.

We have time to commute to and from in-person sessions during the week.

We’re looking for the most efficient option to fit into our schedule.

How important is it to avoid extra driving?*

Very important — we’d love to cut down on driving time.

Somewhat important — depends on the day.

Not important — we’re happy to make the drive if needed.

If online tutoring produced the same results as in-person, which would you prefer?*

Online — easier to manage with our schedule

Hybrid — some in-person, some online

In-person — we’re willing to come into the office each time

If the best tutor match for your child is online, would you be open to starting online and revisiting your format after the first few sessions?*

Yes, we’re flexible

Possibly — it depends on the situation

No, we’d prefer to stick with our original format

Does your child keep his/her own schedule?*

Yes

This field is hidden when viewing the form

Where does your child keep track of his/her schedule?

Phone

School planner/paper calendar

Other

Does your child have a free period with off-campus privileges?*

Yes

This field is hidden when viewing the form

Please provide the days and times of any school free periods.

Does your child currently participate in any activities that involve multiple appointments each week?*

For example: sports, theater, music lessons

Yes

Activity Schedule

Is your child available to meet for two 90 minute sessions per week during the first phase of tutoring?*

Increasing the frequency of meetings in the early stages of prep typically REDUCES the total number of tutoring hours required over the entire program. The early stages of tutoring involve lots of behavioral training, which is one big reason that consistency is key.

Yes

No, not at this time

Please select all days that your child is available for tutoring.*

This answer doesn't lock you into any schedule. We use this information to prepare for the placement consultation so that we can make sure we select a tutor who matches your availability. Please note, however, that Hammer Prep cannot guarantee any days and times...in fact, our most popular tutors typically have the least number of open slots.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Will your child be out of town for extended periods of time in the next four weeks?*

Increasing the frequency of meetings in the early stages of prep typically reduces the total number of tutoring hours required over the entire program.

Yes

Long vacation

This field is hidden when viewing the form

Will your child be available to take full-length practice tests at Hammer Prep?

During the school year, we host proctored practice tests on Saturday at 8:30 AM. During the summer, we typically offer practice tests on Tuesday and Saturday.

Yes

Have you been referred to work with a specific tutor?*

Yes

Tutor's Name

Are there any financial considerations we should be aware of before placement?*

The answer to this question is very important. We've been preparing students for more than 20 years. We know what works...and having enough time with a student is critical. While each program varies based on starting score and score target, we have found that being committed to our estimate for success is important. If you are NOT comfortable investing $4,000 in test prep (i.e. 24 hours of tutoring over several months), please select "No" and we can discuss options during the consult.

Yes, please call to discuss

This field is hidden when viewing the form

Are you interested in tutoring online instead of at the center?

Yes, please call to discuss

Online tutoring works great for the incredibly busy student that can't sacrifice the drive time to the Hammer Prep office in Sorrento Valley.

What are your child's two favorite activities?*

When not in school or studying, how does your student prefer to spend their free time?*

What 3 words best describe your student's personality?*

Could you describe the qualities of your child's favorite teacher?*

How would you describe your child as a learner?*

Self-directed

Needs structure

Other

What additional information would be helpful in placing your child with a tutor?*

When should we plan to start?*

As soon as possible

On a specific future date

Type in your preferred start date*

Need help with the form?

Call 858-793-7737

Email info@hammerprep.com