Intake form

Name *

Email address *

What is your relationship to the student?

What age group does the student belong to?

Which educational programs are you interested in?

Please select at least one option.

After-school programs

Tutoring services

Specialized workshops

Cultural activities

What challenges does the student currently face in their education?

How did you hear about fundación cuenca viva?

What is your preferred method of communication?

Please select at least one option.

Email

Phone

In-person

Text Message

Do you have any specific goals for the student's education?

Which service or services are you interested in?

Please select at least one option.

Fomento lector

Fortalezas del carácter junto a Fundación Astoreca

Taller medioambiental junto a Huerto de permacultura Alma Verde

MUSIC TOGETHER JUNTO A PALOMA GONZALEZ

Extra programaticas

Additional questions or comments

Fundación Cuenca Viva