AlphaVANCE Tutor Spa registration

First Name*

Last Name*

Nick Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Email Address*

MaleFemale

Age*

Grade*

Tutoring Subject(s)*

Membership Type *

Type of Reader *

Type of Session*

Preferred Day(s)*

Session Duration *

Preferred Start Time *

Please select tutoring start date *

Initial Assessment and/or Consultation- Please select only one day (additional cost required)

Are there any specific skills and/or area of focus you would like our tutors to target?*

Help us better understand your student when it comes to academics*

Please help us get to you know your student a little better: their interest, favorite color, candy, character, toy, sports they like, etc.*

Signature

20 Minute Session$50.00

Quantity

45 minute Tutoring & Spa Session 2$60.00

Includes 20 minute tutoring session and nail service

Quantity

60 minute Tutoring & Spa Session 2$75.00

Includes 20 minute tutoring session and two spa services

Quantity

Enter coupon

Total $0.00

Enter the message as it's shown*