Request for Academic Coaching
To apply for an academic coach, fill this form out with all necessary information. Please return this form to Mr. Pickett as soon as you have completed it. You may mail it, email it, hand deliver it, or even take a photo and send it to him as a text. Contact info can be found at elon.edu/elonacademy
Name: Cohort (Iota, Kappa, Lambda):
School:
Let us know which subjects/courses you will need coaching for:
Subject/Course Name: Designation (CP, Honors, AP):
Teacher Name: Teacher Email:
Circle or highlight one: Fall Semester/ Spring Semester
Subject/Course Name: Designation (CP, Honors, AP):
Teacher Name: Teacher Email:
Circle or highlight one: Fall Semester/ Spring Semester
Subject/Course Name: Designation (CP, Honors, AP):
Teacher Name: Teacher Email:
Circle or highlight one: Fall Semester/ Spring Semester
If you receive an academic coach, you are required to meet at least once every other week. Please specify on the next page which times during the week you are available to meet with a coach.
Note: Please indicate all times you could be available. If you are available 3 days per week, this does not mean you will meet with a coach for 3 days. We will try to pair you with a coach whose schedule matches up with yours.
Example: Wednesday: Available from when school gets out at 3 to when soccer practice starts at 4:30.
Thursday: Available before school from 6:30am-7:30am, and after soccer practice from
6:30pm-8:00pm.
Sunday:
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
____ (Initial here) I understand that I must provide my own transportation to coaching meetings, and I have spoken to my parents/guardians about this.
____ (Initial here) I will commit to making every effort to meet with my coach at minimum once every other week.
Is there anything else you want us to know when scheduling? Include any special circumstances or other things that wouldn’t fit somewhere else on the form.