2023-2024 Ladder Learning Services Registration Form

2024-2025 Ladder Learning Services Tutoring Registration

This registration covers services through Aug 31st, 2025. Please fill out one form per student (siblings count together for pricing). If you have any trouble filling out this form, please email ladderlearning@gmail.com or call us at 470-344-5574. Please note, your sign-up on this form does not guarantee a spot, but we will do our best to place you with a tutor. Once we have a spot reserved for you, we will let you know by email. It may be several days before you hear from us, but please feel free to follow up with us at any time. We will also send you the policies contained in this form by email for your reference. Your registration on this form indicates your agreement to abide by the policies listed here.
Your Name*

First NameLast Name
How did you hear about Ladder Learning?
Please let us know how you heard about us.
Your email address*
example@example.com
Student Information

Information about the student this form applies to (please fill out a separate form for each student you are registering).
Student's Name*

First NameLast Name
Student Nickname
Use this if there's a name your student prefers over the above.
Student Email (if applicable)
Enter student's email if they will need to receive Zoom links and other information.
Student Phone Number (if applicable)
Enter student's phone number if we may need to reach the student directly.Format: (000) 000-0000.
Student's Grade Level for the 2024-25 school year*
School Student will be attending in 24-25 school year (if known)
Student's Date of Birth

MonthDayYear
Date
He/him/hisShe/her/hersThey/them/theirsOther

Other Student Information
What are the student's feelings about participating in tutoring?
Enter if Applicable
Does this student know about their learning challenges? What are the student's feelings about the challenges they face?
Enter if Applicable
Tell us about this student's hobbies/interests
What motivates this student?
Is there anything else we should know about this student?
Please include anything else you'd want the student's tutor to know in order for the tutor to connect with the student.

Tuition Payments

All tuition payments are due the 1st of the month and are the same amount every month. Some months will have more lessons than others. Any accounts past-due may be subject to suspension of lessons. Please let us know if you will have any difficulty paying your tuition on the 1st so we can make other arrangements. We require all parents to put a credit/debit card on file on "autopay" or to put down a deposit equal to half a month's tuition. Please note that consistently late payments may result in your student losing their tutoring spot.
Choose a Payment Method*
Note: if a school or other fund is paying LLS for this student, please make sure they have contacted us to set up arrangements for payment.
Choose a deposit or autopay option*
One of the following options for payment must be selected.

Parent or other party responsible for payment

Please enter the information for the parent/guardian or other party who is primarily responsible for payment. (Note: we will need to have ONLY ONE individual who is responsible for payment. We cannot split up invoices between multiple parties.)
Name*

First NameLast Name
Employer*
Parent/Guardian 1's employer
Relationship to student*
Phone Number (primary)*
Format: (000) 000-0000.
Phone Number (secondary)
Format: (000) 000-0000.
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other Parent/Guardian Information

If applicable, please enter the information about an additional parent or guardian for this student. This person is not primarily responsible for payment but may need to have access to lesson notes or be contacted for scheduling.
Name

First NameLast Name
Relationship to student
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address (if different from Parent/Guardian 1)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Assessment ReportsWeekly Lesson NotesCommunication about Scheduling

Next Steps

We will match you with one of our qualified specialists and schedule the lessons with you ASAP.

If you are a new client and need an initial placement assessment, we will schedule an initial assessment as soon as possible. In some cases, we may be able to take another recent evaluation from a tutor or learning center in place of our assessment; please let us know what evaluations you already have by sending them to us at ladderlearning@gmail.com or uploading them below.
Upload relevant evaluations, assessments, or other documentation that may help us to make the most accurate assessment possible.

Cancelof
Tutor Placement

You will be matched with a tutor based on your student's needs and your schedule. If you require a schedule change mid-year, you may need to switch tutors. All of our tutors are highly-qualified specialists. If you ever have any problem with your assigned tutor, please contact the office at ladderlearning@gmail.com
Tutor Preference (optional)
If you have a specific tutor you would prefer, please indicate that here. If this is your current tutor, we will try to keep you with them, however it will depend on their availability.
Ladder Learning Services operates on a tuition-based payment model. Tuition is charged monthly, and is the same each month regardless of the number of days in that month. We plan for a total of 45 weeks of instruction from September to August of the following year. Tuition is split into 12 equal payments and due the 1st of each month. Some major holidays will be taken off along with a winter break. These days off are built into the price so no refunds are issued for sessions that would occur during those breaks. Your tutor will get 1 'flex' week of vacation and you will also get 1 'flex' week of vacation, to be scheduled at any time during the term.

You are free to end services at any time. We require at least 14 days notice prior to the start of the next billing cycle. This notice should be sent in writing, by email, to LadderLearning@gmail.com. No refunds will be issued for early cancellation.

Note: If your school is paying us for services and we have a separate arrangement worked out with them the above information may not apply. We will bill the school directly.
I agree
Included Services

Lessons include 50 minutes of instructional time (unless otherwise agreed) and 10 minutes of preparation time for the tutor. You are free to have a conference with your tutor at any time during the assigned 50 minutes. If you need more time to go over anything, please contact the LLS office or your tutor to set up a time outside of lessons to meet. Please respect that your tutor's time is tightly scheduled and they can not stay past your appointed ending time.

Tutors will typically send weekly lesson notes for any students who are scheduled for at least twice/week. Once/week students will get monthly or quarterly notes. We also keep periodic assessment data for progress-monitoring. If you would like access to this additional data, please let us know and we can send that to you.

Your tutor, the Director, or the LLS Advocate can be made available to attend your IEP/504 meetings to answer questions about our programs for our hourly meeting rate of $80/hour. This additional cost will be added to your next month’s invoice. If you require additional advocacy support at these meetings, please contact the LLS office. Our LLS Advocate does have a private company that can guide you through the Special Education process. You can learn more about these services by visiting northgeorgiaadvocacy.com.

We are available to re-test the student's initial assessment testing for an additional fee (as long as it has been at least 6 months from the initial testing date). Please contact the LLS office to set this up.

Students who need supplies (math blocks, handwriting book, etc.) beyond what is typically provided may need to purchase this at an additional charge. Every effort will be made to provide affordable options, and you will be asked ahead of time before we bill you anything beyond your typical tuition rate.
I agree
Required Technology Policy

For online multisensory tutoring to be effective we require the following:
- A stable connection with 2Mbps+ download and upload speeds (you can check this at www.speedtest.net)
- A computer or tablet (not a phone) with a browser
  - PC: Chrome, Edge or Brave
  - Mac: Chrome, Edge or Brave
  - Chromebook: Chrome
  - iPad: Safari
- A headset with a microphone
- A quiet, distraction-free location (not in a car)
- Sitting at a desk or table
- An adult nearby who can troubleshoot any computer issues
I agree
I agree
Confirmation

By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original, manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty:

2024-2025 Ladder Learning Services Tutoring Registration

Student Information

Student Health Information

Educational Concerns

Other Student Information

Tuition Payments

Lesson Packages

About our Payment Model

Scheduling

Parent or other party responsible for payment

Other Parent/Guardian Information

Tutor Placement