Tutor Application

Parent Name

First NameLast Name

Student Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail Address

Phone Number

Format: (000) 000-0000.

Student's Birth Date

MonthDayYear

Male/Female

How did you hear about us?

If someone referred you, please type their name here. If not, type N/A.

When would you like to start?

What subjects/skills is the student needing help with?

Choose grade level.

Hold CTRL for multiple selections

Days available for tutoring

Brief description about student/child.

Brief description of student's likes/dislikes. Toys, food, snacks, etc.

What would you'd like for your student/child to get gain from these sessions?

Any questions/concerns you'd like for me to address during consultation?

Do you prefer your child/student to do 1-on-1 sessions only or group sessions? (Please type preference below).

Can child/student be recorded or photographed for marketing purposes? (yes/no)

Payments

All payments should be paid 48 hours (2 days) before session.

Payments may be paid in advance.

If payment isn't made before session, your session will be CANCELLED.

All payments will be recieved through invoice.

Scheduling

Sessions can be booked (Monday-Thurday) 9am-5pm & (Friday) 9am-3pm.

Scheduling is 1st come, first serve so book in ADVANCE if possible.

You must commit to (2) sessions per week.

Sessions must be "paid in full" upon arrival or session will be CANCELLED.

**Please refer to payment section for terms**

All sessions are an hour.

You CAN NOT break up an hour session.

You can add an additional hour for a DISCOUNTED fee.

If you need to re-schedule, please try to do so 12hrs in advance or ASAP!!

You'll be able to re-schedule the session for the next day or week available.

Arrival Time & Late Arrivals

**Please be on time for every session.**

A 30-minute grace period will be allowed, but a $10 late fee will be added to the session.

**This fee must be paid upon arrival.**

You will ONLY have the remaing time within that hour for your session due to other sessions already scheduled.

If you arrive after 30 minutes, your session will be CANCELLED.

**Communication is KEY**

If there is an emergency & you have to re-schedule a session, please let me know ASAP via phone call.

If an emergency arises with myself, I will give you the same courtesy.

No Call/No Shows

If you know that you won't be able to make a session, please communicate that &

RE-SCHEDULE.

**See schedling section for terms.**

(1) No-Call/No-Show will result in you not being able to book for a week.

(2) No-Call/No-Show will result in you not being able to book INDEFINETLY.

I understand that things happen & emergencies may arise, so please send a courtesy call. I'd greatly appreciate it.

Rates

Pre-K & Kindergarten ($25 per session)

1st & 2nd grade ($30 per session)

3rd, 4th, & 5th grade ($35 per session)

**Group session of 2 or 3 (if available), will recieve a $5 discount**.

**All payments will be sent through an invoice**.

Please upload any school work from past school year that student may need extra help in?

By signing this contract, you agree to all indicated terms, policies, and agreements. If you "agree", please type "Agree" below.

Signature

Date