Student Name*

What are the first words that come to mind when describing your son/daughter?

What are your son/daughter's academic strengths?

What are your son/daughter's academic challenges?

What activities does your son/daughter enjoy outside of school?

What expectations or goals do you hope will be met regarding your son/daughter's participation in BASS?

How did you learn about Brewster Academy Summer School?

Please list other comments or information that may be useful to us.

Parent Name*

Address

Phone

Email*