Academic and College Coaching
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Please select your preferred date & time for your initial Academic Advising session/assessment (Remaining hours, if selected above, will be scheduled on your initial visit.)
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Choose your plan
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Academic Advising - Pay as you go
per hour
$
125.00
Number of Hours
1
2
3
4
Academic Advising - 5 hour Package
$
500.00
Academic Advising - 10 hour package
$
900.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Student's Name
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First Name
Last Name
Student Phone Number
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Please enter a valid phone number.
Student Email
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Grade
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Numbers Only
School Name
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Latest GPA / Percentile
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Did the student receive any recognition, citation, or awards?
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Mother Name
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First Name
Last Name
Mother Phone Number
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Please enter a valid phone number.
Mother Email
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example@example.com
Father Name
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First Name
Last Name
Father Phone Number
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Please enter a valid phone number.
Father Email
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example@example.com
What are you looking for your child?
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MATH Assesment
English Assesment
College Application
SAT Prep
Guidance with choosing a major
Other
Which subject/Topic/Area?
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Please explain your concerns or the topic you would like to discuss
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Informed Consent
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Signer Name
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First Name
Last Name
Signer Signature
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Date Signed
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Month
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Day
Year
Date
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