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ACT One: Access. Connect. Transform.
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Virtual Academy Individual Coaching Request
Student Name
*
First
Last
Student Grade in Fall 2020
*
Private Coaching is only available for students in 4th grade and older.
Please Select
4th
5th
6th
7th
8th
9th
10th
11th
12th
Date of Birth
*
Date Format: MM slash DD slash YYYY
Has your student participated in Theatre Arts Training classes?
*
Yes
No
Guardian Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
*
Email
*
Creating the Right Lessons for You!
Type of Coaching
*
Monologue
Song
Please tell us about your students previous experience
Please tell us what you hope to accomplish in private coaching
Describe your students ideal learning environment:
characteristics of an ideal teaching artist, student learning styles, learning accommodations, etc.
Availability
Please indicate the times and days you are available to attend lessons.
*
Enter available times for each day in the boxes below. You can add more than one time-frame per day by clicking the "+" on the right-hand side. If you are unavailable on a day, please leave the box blank or enter "N/A"
Sundays
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
How many sessions would you like to schedule
*
each session is 1 hour long
4 session bundle | $220
8 session bundle | $400
Required Acknowledgments
I understand that a parent/guardian must be present for all private coaching sessions and give permission for the coaching session to be recorded for safety and archival purposes.
*
Yes
Is there any other information you would like to provide?
×