District Administrators

Please complete the following survey. A program representative will be in contact.

School Campus(Required)

Principal's Name(Required)

First Last

Point of Contact Name(Required)

First Last

Office or Cell Number(Required)

How did you hear about our program?(Required)

Number of students to be served(Required)

Projected # district campuses to be served(Required)

Grades to be served(Required)

Tentative Start Date(Required)

Month

Day

Year

If known, what is the budget amount for services?

What is the budget per student? Per program? Math only? Reading only? Math and Reading?

What is your preferred date and time to meet via Zoom to discuss this program?(Required)

Subjects to be provided. Choose one.(Required)

Math only

Reading only

Math & Reading

Type of service needed. Choose one.(Required)

In School tutoring

After school tutoring

Summer Bridge

Does each school location have a dedicated room for In-School tutoring from Monday to Friday?(Required)

Yes

No

Does each school location have a dedicated room for After-School tutoring for 2-4 days a week?(Required)

Yes

No

Does each school location have a dedicated room for Summer Bridge tutoring for 2-4 days a week?(Required)

Yes

No

Does each district have a dedicated liaison for the Beacon Hill Partnership?(Required)

Yes

No

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1402 CORINTH STREET, SUITE 257
DALLAS TX 75215
P: (972)329-7779
F: (972)329-0951
info@beaconhillprep.org

Beacon Hill is a 501c(3) Nonprofit Organization.

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