NEW STUDENT REGISTRATION
One-time Registration Fee: $65
Parent's Names
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mom's Cell
Format: (000) 000-0000.
Dad's Cell
Format: (000) 000-0000.
Parent Email
example@example.com
Student Information
Student Name
First Name
Last Name
Student Address (if different from parent)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Phone
Format: (000) 000-0000.
VENMO USERNAME
School Name
Teacher's Name
Grade Level
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Specific areas of concern
Start Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Projected End Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Days Requesting Tutoring per week (circle all that apply) M T W R
M
T
W
R
Hours Requesting Tutoring each week
TUTORING AGREEMENT: The fee for tutoring for one hour per week, one-on-one with the tutor is $ 55 per hour; two hours or more per week is $50 per hour. Payment is due at the beginning of each month for the month by VENMO to @MTAYLOR-TLC.
Since our tutors specifically schedule with your child, please be mindful of their time and if your child will not be able to attend a session due to a scheduling conflict, let us know at the beginning of the month so we may schedule an alternate appointment time for that week.
We understand that emergencies occur, and if we are given 24 hours notice of a cancellation, there will be no penalty; however, less that 12 hours before a session is scheduled will result in a $25 cancellation fee, and a no show will result in forfeiting that week's payment. Call or text: 850-556-8163 for cancellations.
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