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Initial Family/Learning Pod Registration Form
 

Please provide details about the placement location. If multiple families are forming a Learning Pod, please provide the address where the Learning Pod will be hosted.

 

If you are looking for a placement for 1 or 2 students, please contact us for pricing. 

 
Primary Contact
 
For Learning Pods with more than 1 (one) family, please identify a single primary contact and provide those details for the entire Learning Pod. (Individual contact information for each student's parent/guardian will be collected later.)
 
 
 
 
As a reminder, placements can be made on a weekly basis, beginning every Monday. Placements must be made two weeks in advance for scheduling purposes. If you are looking for a longer-term placement, please notify us once your placement is confirmed so we can extend your placement records.
 
By checking "I Understand" below, you acknowledge that placement requests must be made 2 weeks in advance or they may not be fulfilled. You also acknowledge the Hello World AZ Cancellation Policy.
 
 
Schedule Details
Shifts and days requested are not guaranteed availability. All requests are pending until you receive your confirmation email with your Facilitator placement.
 
 
Days Requested *
 
 
 
 
 
 
 
 
Please share any details about the placement or students that you think would be important for us to know when making our match to your Facilitator.