Haque Tutoring New Client Intake

Haque Tutoring New Client Intake

Please complete this form to help us understand your tutoring needs. We'll use this information to match your student with the best support and contact you to schedule a consultation.
Parent/Guardian Name
Student Name
Please provide at least one Email & Phone Number
Parent Contact Email
example@example.com
Student Contact Email
example@example.com
Parent Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Student Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Contact Method
Tell us more about your student
Student Grade Level
School Name
City/Area for In-Person Sessions & Scheduling
Primary Subject(s) for Tutoring

Other
Specific Course(s) or Exam(s) (please specify, if applicable)
Current Challenges or Learning Difficulties
Student Strengths and Interests
Goals for Tutoring
Preferred Session Style
Preferred Meeting Format
Preferred Days/Times for Sessions
How Did You Hear About Haque Tutoring?
Additional Notes or Questions
I understand that Haque Tutoring provides ethical, honest tutoring and will not complete assignments or exams on behalf of the student. I understand that specific rates, availability, and meeting locations will be discussed and confirmed during the consultation.
Should be Empty:

Please provide at least one Email & Phone Number