Tutoring Application

1
Applicant Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
Please enter a valid phone number.
4
Emergency Contact Name* This field is required.
First Name
Last Name
5
Are you the parent/guardian of applicant?* This field is required.
YESNO
6
Emergency Contact Phone Number* This field is required.
Please enter a valid phone number.
7
I need help with (please select all that apply):* This field is required.
Reading
Language Arts (Writing, grammar, etc.)
Math
Social Studies
Science
Other
8
What is your grade level or age?* This field is required.
9
What days/times would best suit your schedule? Please choose from the list below:* This field is required.
Tuesdays 10-11 am
Tuesdays 2-3 pm
Tuesdays 11-12 pm
Tuesdays 3-4 pm
Other
10
In the provision of educational services, every effort has been made to provide a professional and high-quality setting that is free for the community. Anyone desiring support to reach their educational goals is invited. We can guarantee our optimum effort to make this study rewarding, but, of course, the end result depends on both parties' efforts. We can make no guarantee except to provide an environment of dedicated service to increase your knowledge and expertise in solving problems and critical thinking skills based on criteria included in a graduation exit exam format. We are also offering specialized tutoring for ages 12 and up. This program is not sponsored by Bossier Parish Schools.
11
SignatureIf you are under 17, please have a parent or guardian sign.
Clear
12
By clicking below, you agree to attend as you are scheduled and notify the instructor of any absences due to sickness or emergencies. You are also agreeing that you will commit to trying each method we offer to find the style of learning best suited for you.* This field is required.
I agree to follow instruction and commit to learning new and different ways of studying so that I can find the learning style best suited for me.
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