Tutor Request Form

Program Overview (K-12 only)

At Lil Readers, we have highly qualified tutors who provide reading, math, and science tutoring to Kindergarten through 12th grade students. Students can engage in two or three 45-minute sessions per week, each tailored to their individual needs. With a teacher-to-student ratio of 1:5 for K-5 and 1:10 for 6th-12th, we ensure a supportive learning environment. Plus, we offer a 10% discount for siblings, making our high-quality education more accessible to families. Please allow our staff 3-5 business days from submission to confirm your schedule. Cost of Attendance: Two days of tutoring per week= $200 per month, three days of tutoring per week= $275 per month.
Personal & Contact Information

Please make sure all information is accurate.
Student's Name*

First NameLast Name
Grade*
Gender*
Birth Date*

MonthDayYear
What school does your child attend?*
Which location are you enrolling in?*

North Little Rock (Open Monday - Thursday)Little Rock (Open Tuesday & Thursday only)
Which subject(s) would you like your child to receive tutoring in?*

ReadingMathOther
How did you learn about us?*
Does your child have any learning disabilities or any behaviors that we should know about? Providing this information helps with developing a learning plan that's catered to your child. *
If you have a copy of student data, upload here. (acceptable data: NWEA scores, ACT Aspire scores, reading level data, report cards only if it is skilled based with a number rating of 1-4)

Cancelof
Parent's Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Will you be signing up any siblings? If yes, please provide name and grade. (You will need to fill out a separate request for each child.) *
Tutoring is more impactful when students are enrolled continuously for at least 3 months. We also offer a 10% discount for parents who register for a semester (3 months total). However, we can be provide tutoring on a month to month basis. Which option do you choose?

MonthlySemester I (September - December)- Students must begin week of September 8 for this option
Select Start Date*

Week of September 8Week of October 6Week of November 3
You have the option for your child to receive tutoring 2 or 3 days per week. How many times would you like them to tutor?*

2 (45 minute sessions per week)3 (45 minute sessions per week)
Our NLR location is open Monday - Thursday. Which days would you prefer?*

MondayTuesdayWednesdayThursday
Select a start time that works best for you. We meet Monday-Wednesday. The times you select are the times you are able to commit to.*

3:00pm3:15pm4:00pm4:15pm5:00pm5:15pm6:00pm6:15pm
Would you like to use AfterPay as a payment option?*

YesNo
Do you have any additional comments/concerns?*

My Products

New Student Registration FeeThis non-refundable registration fee guarantees the student spot for tutoring sessions. Fees will be used to purchase student supplies. It is not applied to total costs.

$15.00 Quantity

Returning Student Registration Free This is ONLY for students who were in our program during 2025. This is a non-refundable registration fee guarantees the student spot for tutoring sessions. Fees will be used to purchase student supplies. It is not applied to total costs.

$10.00 Quantity

Total

$0.00

Payment Methods

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Program Overview (K-12 only)

Personal & Contact Information

Payment Methods