Reading + Math Mastery Form
Parent/Guardian Information:
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Preferred Method of Contact:
*
Call
Text
Email
Student Information
Name
*
First Name
Last Name
Grade Level:
*
Please Select
1st
2nd
3rd
4th
5th
6th
Name of School:
Optional
Area of Focus:
*
Math
Reading
Both
What are your learning goals? What is your child struggling with?
*
Scheduling Preferences
Time Zone:
*
Student Placement
1. Upload any optional documents ( IEP, recent report card, teacher notes ) 📎 2. Or type your concerns in the box below.
*
File Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Program Selection
Program Selection:
*
Full Reading & Math Mastery Program – $197 / month
Single Subject (Reading or Math) – $127 / month
Policies & Agreements
Every student receives a brief placement assessment before starting.
*
I understand my child will complete a pre-assessment before placement.
I understand that tuition is billed monthly and auto-renews unless canceled with 7-day notice.
*
Yes
I agree to submit weekly assignments and attend scheduled sessions.
*
Yes
I understand that missed classes can be made up via recordings or rescheduled as available.
*
Yes
Submit
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