Intake form

Name *

Email address *

What is your child's age?

Which learning level are you interested in?

Please select at least one option.

Creative Thinkers (under age 4)

Bright Builders (ages 4-5)

Readers & Makers (ages 5-7)

What are your preferred class days?

Please select at least one option.

Monday

Tuesday

Wednesday

Thursday

Friday

What is your preferred class time?

Please describe any specific needs or interests your child has.

Which service or services are you interested in?

Please select at least one option.

Creative thinkers program

Bright builders program

Readers & makers program

The penholic artsy party lab

Little makers art lab

Penholic creations

Initial consultation for $150

Follow-up consultation for $100

Additional questions or comments

Penholic Academy