SEA STUDENTS’ READINESS WORKSHOP | Axiom Counselling and Development Consulting Services Ltd.

PERSONAL INFORMATION

Name of Child (Participant):

Age:

Name of Parent/Guardian :

Contact:

Address:

Email:

Emergency Contact:

Primary School Attending:

SEA Students’ Readiness Workshop:
Phase I (Personal Readiness)Phase II (Academic Readiness)

Phase III (Career & Secondary School Readiness)

ACADEMIC HISTORY

Standard 3 - Overall Grade:

Standard 4 - Overall Grade:

Standard 5 –Grade:

Subject Areas in which son/daughter is good at:

Subject Areas in which son/daughter is weak:

(Please provide brief information on what might have been done to assist by school, parent or other relevant persons):

EXTRA CURRICULAR INTEREST/ Activities Student participate in (outside of academic studies – Eg. Football, chess, scrabble, netball, cricket, dancing etc):

PRESENTING CONCERNS

Poor study skills

Poor Academic Performance

Difficulties stay on task and focused

Disruptive Behaviour

Disinterested/Unmotivated in studying

Learning Disability

Emotional Distress

Other: (please provide some details):

Payment Information and other Relevant Information:

Please make deposit into Scotiabank Account# 001211205: Axiom Counselling (Tunapuna Branch).
Please note the following:

A place in programme is only confirmed after receipt of payment.

There will be four (4) sessions in this programme. Each session begins promptly at 4pm and ends at 4:50p.m. As the space being used is booked for this period only. Please therefore ensure children are ON TIME and collected ON TIME at end of session.

Students are required to attend all sessions as a pre assessment is given to the student at the start of the programme and another is given at the end of the sessions to measure student progress/improvement and also provide you the parent with further strategies to continue providing guidance.

Material given to student is not to be reproduced and shared with persons who have not attended the sessions.

Please ensure child attends each session with pen, pencil, ruler, erasers along with a copy book or small notebook. All working material/worksheet activities will be provided by us.

REGISTRATION FORM (SEA STUDENTS’ READINESS WORKSHOP)