Registration Form
Fill out the form carefully for registration
Student Name
First Name
Middle Name
Last Name
Grade Level:
Ex: 7th grade
Which subject(s) do you feel you need the most help with? (Select all that apply):
Rows
Subjects
Math
English/Language Arts
History/Social Studies
Other
If you clicked "Other", please indicate why:
Within the subject(s) selected above, what specific topics or skills do you find most challenging?(For example, fractions in Math, essay writing in English, etc.)
Are there any particular assignments, projects, or tests you struggle with? If yes, please describe:
Why do you think you are struggling with these subject(s)? (Select all that apply)
Rows
Reasons
I don’t understand the material.
I don’t understand the material.
I need more practice with certain skills.
I don’t have enough time to study.
Other
If you clicked "Other", please indicate why:
What learning methods work best for you? (Select all that apply)
Rows
Methods
One-on-one instruction
Small group activities
Hands-on practice or experiments
Reading and taking notes
Other
If you clicked "Other", please indicate why:
Is there a specific goal or topic you’d like to focus on during tutoring sessions?
Is there anything else you would like your tutor to know about how you learn best?
Do you have any other concerns, questions, or information you’d like to share?
What days can you come in for tutoring?
Monday
Wednesday
Both
What is your learning style? (Select all that apply)
Step-by-step explanations
Guided questions
Visual examples / diagrams
Practice problems / exercises
Other
If you clicked "Other", please indicate why:
When you get stuck on a problem, what do you usually do and how do you feel?
How would you describe your temperment?
Any other notes on your personality?
Submit
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