The EduPlay Learning Experience

Working together to build your child’s confidence and independence as they learn through a curriculum designed specifically for your child by an experienced Elementary and Special Education Educator.

From A-Z and everything in between, we prepare them for a lifetime of success!

Please complete the short questionnaire below prior to our call.

Full Name *

Email *

Child's Name *

Let's Hear More About Your Family

Age Range *

0-2 years old

3-5 years old

6-9 years old

10+ years old

Other

Other (Please Specify):

What are some things you would like to know more about? Check all that apply. *

Routines and structure in the home

Ways to incorporate the kids in everyday tasks

Educational Activities

Ways to make learning fun

Resources that meet your child's specific needs

Does your child have any strengths or weaknesses in certain Academic or Life skill areas? If so, please elaborate. *

Is your child able to.... Check all that apply *

Play independently

Play well with others

Share in a group setting or with others

Listen and comprehend when spoken to

Complete tasks when asked

Follow simple directions

Other

Other (Please specify):

Currently, do you have any specific areas of frustration? If yes, please explain. *

Please identify any specific goal(s) you would like your child to accomplish? *

Goal 1
Goal 2
Goal 3

How many hours is your child on a screen (TV, tablet, iPad, computer, phone, etc.)? *

0-30 minutes a day

1-2 hours a day

3-4 hours a day

5-6 hours a day

Other

Other (Please Specify): *

When it comes to routines and structure in the home, are there specific things that do or do not work for your family? Please explain below.

What do you love most about being a parent? *