Tutoring Request

Tutoring Request

Please complete this form and allow us at least 48 hours to review it. We will contact you with tutoring availability and details how to schedule your sessions. Please note that tutoring is not fully booked until a tutoring agreement has been signed and payment has been made.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Method of Contact*
Which service are requesting tutoring for?*
Which School/Program did you attend or applying to?*
Program Expected Completion Date?*

MonthDayYear
Date
Do you have a test date? If yes please list here

MonthDayYear
Date
Are there any days of the week that you prefer? If yes please list here*
Do you prefer virtual or In person? *
How are you currently studying (Include textbooks, exam software and/or study strategies? *
Provide specific details
Add Additional Notes that may be helpful to map out your tutoring plan (Such as weak areas, struggle points, language barriers etc).
If you a repeat NCLEX tester. Please upload your Candidate Performance Report (CPR) results.

Cancelof
If you are repeat NCLEX tester, please list the number of times you have set for the NCLEX exam*
Acknowledgement and Policies

I understand tutoring sessions must be scheduled in advance. I understand cancellations must be made within 24 hours. I understand tutoring does not guarantee exam outcomes. I understand tutoring sessions require payment prior to the session. I understand that signing this document means that I have acknowledged these policies. Once your request has been submitted please allow at least 48 hours for review and we will contact you for availability and scheduling.
Signature*

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Tutoring Request

Acknowledgement and Policies