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Private Tutoring Registration Form

One Time Registration Fee of $25 & Testing Fee of $50 Per Subject

Session must be paid in advance

Payment Plans Are Avaliable

After payment for your child tutoring they will be tested and an individual learning plan will be created to improve their areas of weakness.

Tutoring will be expected to begin within one week of payment.

If you have more than one student please fill out one form for each child.

Parents Information

Students Information

DOB

Home Phone

Parents Phone

Present School

Grade

School Address

First Name

Subject 1 ( Need Help )

Subject 2 ( Need Help )

Subject 3 ( Need Help )

State

Zip

Home Phone

Cell Phone

Email Address

First Name

Last Name

Address