Mailchimp Survey

Homeschool Consultation Questionnaire
First Name
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Last Name
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Email
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Check to subscribe and you will receive my very important email.
Phone Number
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Have you homeschooled before?
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Yes
No
What is your current situation?
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My child left traditional school and now we want to homeschool.
My child left virtual school and now we want to homeschool.
I am homeschooling but need assistance with my program and/or organization.
I have been homeschooling but I am looking for a different program.
None of the above.
If you chose none of the above, please explain.
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What is the age or are the ages of the homeschooled children?
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What gender is the child or what gender(s) are the children?
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Does the child or do the children have special needs?
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How would you describe the child or children behaviors and moods throughout the day.
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Are you interested in homeschool evaluation services?
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YesNo
If you answered yes to the question above, when would you like to start?
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Soon As PossibleOne month from NowTwo or more months from Now
What type(s) of consultation do you want?
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Option #1- Receive 3 detailed email messages to address the situation $99.99.
Option #2- 20-Minute Phone Homeschool Consultation $130 and email notes
Option #3- 30 Minute Zoom Consultation $190 and email notes
Option #4 -60-Minute Zoom Consultation $350 and email notes
Option #5- 20 Minute Phone Follow-Up Consultation to answer any questions and/or concerns $30
None of the Above
I have an online homeschool program where I provide all the online resources for the curriculum and the 1 to 1 teachers for each of your child’s core subjects. Would you be interested in learning more about my program?
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Yes
No
Once the questionnaire is completed, you can sign up for a free 20 minute phone consultation with us here https://diverseilearning.com/booking-calendar/ to verify that I understand everything completely before the official meeting or the paid emails are sent. (The free 20-minute meeting is already included in option#1 booking process.)
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Yes, I understand the statement above.
What questions or concerns do you want discussed in our meeting?
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How did you hear about us?
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Which products and services are you interested in?
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Tutoring, Teaching, and on Curricula Services
Homeschool Consulting
Special Education Consulting
Life and Health Coaching
Educational Products
Apparel and other products
Please check the All Mail in your email if you don’t see our email response!

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