Mankato Math & Me Punch Card Registration
Welcome! Thank you so much for selecting Mankato Math and Me! Please reference this document for more information about our services and procedures at https://mankatomathandme.com. If you are registering more than one child, please fill out two separate forms! Contact info@mankatomathandme.com with any questions or help completing the form or visit mankatomathandme.com.
This form is for the Punch Card only. If you are looking to sign up for our regular school-year programs, please visit this form instead: https://form.jotform.com/221698027175158
I have purchased a Mankato Math and Me Punch Card before OR am a previous client of Mankato Math and Me and have no new information to update regarding my child and parent/guardian information.
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About your child
Child First Name
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Child Last Name
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Child Pronouns/Gender
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Child Birth Day
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Month
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Day
Year
Date
School
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Child's Grade Level in the 2023-24 School Year
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Name of Student's Math Course (if Pre-algebra or above)
Math & Me LOVES to bring little goodies for the little ones! Please list ANY allergies or foods we should avoid or be aware of. Please also describe any physical and/or mental conditions that you would like Mankato Math and Me to be aware of during tutoring. Type N/A if none.
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Parent/Guardian Information
Parent/Guardian First and Last Name
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Parent/Guardian Email
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Parent/Guardian Mobile Phone Number
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Parent/Guardian Work Phone (if applicable)
Emergency Contact First and Last Name
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Emergency Contact Email
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Emergency Contact Primary Phone Number
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How did you hear about Math and Me?
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Anything else to share? Other skills that can be addressed if time? Learning preferences or styles?
Although optional, we highly recommend you email (info@mankatomathandme.com) OR upload photos or PDFs of some of your child's work in order for us to gage the level of where your child is currently at. This is extremely beneficial for us to plan sessions for the most effective learning.
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Child First and Last
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Parent/Guardian Name
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Parent/Guardian Email
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By checking the box below, I have read and agree to Mankato Math and Me LLC's Terms of Service, which can be found here: https://docs.google.com/document/d/1iT1MNACWYdoptcEKTh62ROaBm0xIiv021rlRGG4PS5U/edit
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I have read and agree to Mankato Math and Me LLC's Terms of Service
Punch card (must click box in order to process)
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Punch Card
$350.00
$
350.00
Quantity
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Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Thank you! We look forward to meeting you and your child!
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