Math Doctor: Student Registration (School Year 2023

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Who is filling out this form?* This field is required.
Parent/Guardian
Student
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Name of Parent/Guardian* This field is required.
First Name
Last Name
3
Parent's Email* This field is required.Invoices, agreement forms, and important communication will be delivered here.
example@example.com
4
Parent's Mobile Phone Number* This field is required.In the event that your child hasn't shown up to class, we will be contacting you at this number.
Area Code
Phone Number
5
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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Student's Email* This field is required.An event invitation (with the Zoom meeting link) will be sent to this email address.
example@gmail.com
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Student 2's EmailKindly skip the question if this doesn't apply.
example@gmail.com
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Student's Mobile Phone Number* This field is required.Tutors at Math Doctor are trained to contact the student directly if the student hasn't shown up 5 minutes past scheduled time.
Area Code
Phone Number
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What grade is the student currently in?* This field is required.As of September 2023
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Which school does the student go to?* This field is required.
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Precisely which subject(s) are you looking for support?* This field is required.Although not required, kindly share with us the Course Code if possible.
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Are you looking for Homework Help or Math Enrichment?* This field is required.This will give the tutor a better idea of how to organize their lesson plans.
Homework Help
Math Enrichment
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How does your child learn best?* This field is required.We will tailor our instruction based on your response.
Visual: Learn by Seeing
Auditory: Learn by Hearing
Read/Write: Learn by Note-taking
Kinesthetic: Learn by Doing
Unsure
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For in-home tutoring, this map shows the area we're comfortable travelling to.Status as of August 2023: Available
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Please share with us your address or closest major intersection.* This field is required.
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Which weekly tutoring plan would you like to sign up for?* This field is required.Effective: August 2023
In-Home 1-on-1 Tutoring ($75 per hour)
Virtual 1-on-1 Tutoring ($65 per hour)
Virtual 1-on-1 Tutoring ($55 per 45 minutes)
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Do you have a preference on which tutor you'd like to go with?* This field is required.
Preferably a Female Tutor
Preferably a Male Tutor
No Preference
Tim Chan (+$10 per session)
Other
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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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What day(s) and time(s) of the week works best for the student(s)?* This field is required.Kindly include 2 or 3 options.
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When would you like your child(ren) to start weekly tutoring?* This field is required.
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?
24
How did you hear about us?* This field is required.
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Terms and Conditions* This field is required.(Updated: August 2023)
Should be Empty: