Assessment

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First Name

Last Name

Phone

Email

How many children do you have?

1 2 3+

What grades are they in?

Grades 1 to 2 Grades 3 to 5 Grades 6 to 8 Grades 9 to 11 Grade 12 Kindergarten Other

Are you satisfied with the current level of education your child is recieving?

Excellent Good Average Poor

Assessment Datetime

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