Math Doctor: Student Registration

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Who is filling out this application?* This field is required.
Parent/Guardian
Student
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Name of Parent/Guardian* This field is required.
First Name
Last Name
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Name of Student #1* This field is required.
First Name
Last Name
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Name of Student #2Kindly skip the question if this doesn't apply.
First Name
Last Name
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Email* This field is required.
example@gmail.com
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Mobile Phone Number* This field is required.
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What grade is your child in?* This field is required.
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Which school does your child(ren) go to?* This field is required.
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How is school like for your child(ren) this year?* This field is required.
10
How does your child learn best?* This field is required.
Visual: Learn by Seeing
Auditory: Learn by Hearing
Read/Write: Learn by Note-taking
Kinesthetic: Learn by Doing
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For in-home tutoring, this map shows the area we're comfortable travelling to.Currently unavailable due to the ongoing lockdown restrictions in the city of Toronto
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Please share with us your address or closest major intersection.
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Which program are you interested in enrolling?* This field is required.
In-Home Private Tutoring
Online Private Tutoring
Small Group Tutoring
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Which plan would you like to sign up?* This field is required.
Basic Plan ($60 for 1 hr - One session per Week)
Deluxe Plan ($80 for 1.5 hr - One session per Week)
Prestige Plan ($150 for 3 hr - Two sessions per Week)
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What day(s) and time(s) of the week works best for the student(s)?* This field is required.
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Why are you seeking tutoring?* This field is required.
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If tutoring was successful, what would that look like?* This field is required.
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When would you like your child(ren) to start tutoring?
Date
Month
Day
Year
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Anything else that would be helpful for us to know? * This field is required.Do you have any questions for us?
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How did you hear about us?* This field is required.
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Terms and Conditions* This field is required.
Should be Empty: