YSLC Tutoring Registration Form

YSLC Tutoring Student Registration Form

Fill out the form carefully for registration
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
#2(Student Name)

First NameMiddle NameLast Name
Birth Date(Student 2)

MonthDayYear
Gender
Parent Name (If Student is a minor)

First NameMiddle NameLast Name
Parent E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tutoring Availability: What day of the week works best for your tutoring sessions?
Note: Registering more than one scholar? If your preferred time slot is fully booked, the second student will be scheduled to start 30 minutes after the first
Tutoring Time

Hour Minutes

AM/PM Option
Tutoring Subject
To help us provide the best possible learning experience, please share anything else we should know about your scholar. This could include their learning style, interests, strengths, areas where they need extra support, or any other relevant information that will help us understand them better.
Tutoring Fee Breakdown :
Payment
We add a $3.25 surcharge for each invoice payment. No-Shows or No Call : If a student does not show up for a scheduled session within 15 minutes of the start time without prior notice, they will be charged the full session fee . If payment is not received the day of service or prior arrangements have not been made, you will be assessed a $10 late fee.
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YSLC Tutoring Student Registration Form

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