Student Inquiry Form for Academic Tutoring
After completing, we will email you with our individualized plan and next steps to schedule tutoring.
Student Name
*
First Name
Last Name
Gender
*
Female
Male
Prefer not to answer
Location
*
Greater Cincinnati
Greater Cleveland
Other
High School Graduation Year
*
2026
2027
2028
2029
Other
Parent/Guardian Name
*
First Name
Last Name
Parent E-mail
*
So that we can get back to you
Parent Cell Phone Number
*
-
Area Code
Phone Number
Which high school does he/she attend?
*
What is his/her approximate GPA? (Prefer unweighted)
*
Over 4.0
3.8 - 4.0
3.5 - 3.79
3.3 - 3.49
3.0 - 3.29
2.8 - 2.99
2.5 - 2.79
Below 2.5
For each content area, what type of rigor is being pursued in the junior and senior years? In what level of course work is the student enrolled?
Rows
College Prep
Honors
AP
College Credit
English
Math
Science
Social Studies
What high school math course is the student taking this year?
Geometry (Math 2)
Algebra II (Math 3)
Precalculus
Stats
Calculus
Other
Academic Area(s) for which tutoring is requested
*
Do you have a specific tutor you would like to request? (Contingent on Availability)
Please explain in detail the circumstances which created a tutoring need.
*
Does the student have any special needs, e.g. IEP, 504, ADHD, Disabilities? If so, please describe in detail so we can best serve the student.
Please list any medications your child takes for school and tutoring.
Is there any additional information which would be helpful to LEAP?
Does your student tend to run out of time on standardized tests?
*
Yes
No
Does your student have test anxiety?
*
Yes
No
IF yes, is your child medically treated for anxiety with medication or counseling?
Yes
No
Was your diagnostic/practice taken with LEAP.
Yes, with LEAP.
No, elsewhere.
How did you hear about LEAP/Seeley Test Pros?
*
Would you like to request a specific tutor? If so, please let us know. Note openings barring availability.
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