2019 Cognitive Skills Camp Set-Up QuestionnairePlease indicate which of the following statements are characteristic of behavior your child has exhibited or that reflect statments your child has made about themselves. These questions will help us determine the plan that we design for your child. If there is any question that you are not sure about or that you think happens but maybe not all of the time, check the box anyway and let us know in the comments section at the end of the quesionnaire.Parent's Name* First Last Parent's Email* Parent's Phone*Child's Name* First Last Please select all statements that apply I want a brain boost. I don't struggle with anything. I have difficulty finishing a book. I have to reread paragraphs or pages to remember what I read. It is hard for me to stay focused in class. Math is hard for me. I lose things all of the time. I forget to turn in my homework. I am usually late. It's hard to get anywhere on time. I blurt things out before I can stop myself. I know what I want to say but I have a hard time saying it. I get so nervous when I take tests. I think I know the information before a test, but when I take the test I bomb it. I don't like change. My grades are all over the place. Some days they are good and other days bad. I get called lazy. I have been tested for the gifted program and I qualify. It takes me twice as long to do homework and study as it takes my friends. I don't like to follow rules. Other (Please elaborate in the comments section below)... Comments & Additional InformationPlease let us know any other information that you feel would be helpful to us to design your child's plan.
