High School Tutoring Registration Form

High School Tutoring Registration Form
We have availability for:

Math, Physics, Chemistry, & Biology
Student Details:
Student Full Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Phone Number*
Student E-mail*
example@example.com
Does the student have any learning disabilities?*

YesNo
Describe the students learning disabilities*
Parent Details:
Parent Full Name*

First NameLast Name
Parent Phone Number*
Parent E-mail*
example@example.com
Tutoring Information:
School Full Name*
Waitlisted Courses
Available Courses*

MathPhysicsChemistryBiology
Please list your course names and years*
When does your course start?*
When does your course finish?*

What times of the week work best for tutoring?*

	Mornings	Midday	Evenings
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays

Is the school being invoiced for tutoring?*

YesNo
Payment Plan:

We have two payment plan options:

Pay-As-You-Go (PAYG) and Prepaid 8-Hour Package

Online Pricing:

PAYG: $53 Per hour

Prepaid 8-Hour Package: $384 ($40 Savings)

In-Person Pricing:

PAYG: $70 Per hour

Prepaid 8-Hour Package: $520 ($40 Savings)

Online Tutoring Availability:

Online tutoring is available for students in Canada and the US. (Pacfic Time Zone - Vancouver)

In Person Tutoring Availability:

In-person tutoring is available within Victoria, British Columbia.

Automatic Billing:

For the PAYG plan, your card will be billed on the 1st and 15th of each month for the hours used in the previous pay period.

For the Prepaid plan, your card will be billed when your hours drop below two, with another 8 hours of tutoring.

The prepaid hours can be used at any time, used by any family member, carried over into the next semester, and any unused hours can be refunded.

All prepaid plan refunds are subject to a $25 admin fee.
Pricing

Online Pricing:

$53 Per hour

In-Person Pricing:

$70 Per hour

Online Tutoring Availability:

Online tutoring is available for students in Canada and the US. (Pacfic Time Zone - Vancouver)

In Person Tutoring Availability:

In-person tutoring is available within Victoria, British Columbia.

Payment*

PAYG Online Tutoring1 Hour

$53CAD

PAYG In Person Tutoring1 Hour

$70CAD

Prepaid Online Tutoring8 Hours - Most Popular

$384CAD

Prepaid In Person Tutoring8 Hours

$520CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Where would you like to do In Person Tutoring?*

University of Victoria LibraryCamosun College Library - LansdowneCamosun College Library - InterurbanNearby Coffee ShopNearby Public LibraryAt My Home
How did you hear about us?*

Google SearchSocial MediaOnline Classified AdsPosterReferred by School StaffReferred by TutorReferred by Student / Parent
Newsletter

Yes, subscribe me to the newsletter to get access to: Course Materials, Tutoring Updates, Job Opportunities, etc.
By submitting this form you agree to have your payment method charged with the selected amount.

If you are on the Pay-as-you-go plan, 1 hour of tutoring will be credited and used towards your first tutoring session.
Should be Empty: