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First name
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Last name
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Email
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Phone
Has your student taken the ACT before?
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If yes, how many times?
Highest English Score
Highest Math Score
Highest Reading Score
Highest Science Score
Has your student done ACT Prep before?
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Is your student motivated to improve his/her ACT score?
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No
Not Sure
Yes
Student's goal score
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Has your student shown signs of test-taking anxiety?
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No
Not Sure
Yes
Share any additional experiences or information you believe may be relevant to understanding your student's profile.
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