Registration: One-To-One Tutoring

Course Selected
Rate
Please complete the registration form below

Student's First Name (Required)
Student's Last Name (Required)
Student's Nickname
Student's Cellphone Number (Required)

Street Address

City
State
ZIP

Student's E-Mail (Required)

Student's School
Student's Grade (Required)  
Graduation Year (Required)

Parent E-Mail (Required)

Parent Title
Parent Full Name
Parent Cellphone (Required)  

Which day(s) and time(s) of the week do you prefer for tutoring? Note: tutoring is not available prior to 3:00pm from Sunday to Friday, and is only available in the AM on Saturdays.

Additional Comments
Cancellation Agreement:
A scheduled appointment must be cancelled with at least 24 hours notice. Failure to cancel with proper notice will result in a charge of $90.

I understand and agree to the Cancellation Agreement.