1. INTAKE FORM >>MGL mathstudio
Unit 603, 5734 Yonge St.
Toronto, ON, M2M 4E7
416.222.3692
www.mgllearning.ca
www.prepanywhere.com
Invoice, Receipt, Session Test Report sent via Email.
Please placeamark in bracket if you prefer above reports in paper print( )
STUDENT PARENT/GUARDIAN ADDRESS
MM DD YY
First Name
Last Name
Cell Phone
School
Grade
Email
First Name
Last Name
Cell Phone
Home Phone
Work Phone
Email
Unit #
Street #
St. Name
City
Province
Postal Code
Questionnaire (pleae choose one or more than one choice if it applies)
1. What is the range of student’s average math grades in school?
a. 0-50% b. 51-60%. c. 61-70% d. 71-80% e. 81-90% f. 91-100%
2. What is your objective from studying math at MGL?
a. Preparing for math before entering university
b. Improve current school math grades
3. Does the student use internet for studying?
a. Yes (Website used for studying: )
b. No
4. Is the student in semester curriculum?
a. Yes
b. No, the student is in a 6-month semester program
5. Does the student get a ride to MGL?
a. Yes, parents/guardian will drive student to MGL >> MathStudio
b. No, the student will take public transit or walk to MGl >> MathStudio
6. How did you find MGL? (Please specify in the bracket to allow MGL to better contact you)
a. Newspaper (Name of Paper: )
b. Search Engine (Web Site: )
c. Word of Mouth (Heard From: )
d. Flyer (Seen At: )
e. Other ( )
MGL
mathstudio
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