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Tutor:
Student:
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♦ PARENT/GUARDIAN INFORMATION
♦ Students Over 18 Years Old May Enter Their Own Information
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Full Name:
Email Address:
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Address:
Zip Code:
You May Contact Me By. . . (Check All That Apply):
Phone Call & Voicemail
Text Message
Email
City:
Phone Number:
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♦ What essential information do your clients need to understand & agree to?
♦ Tutoring Services Required
Grade Levels
Phonemic Awareness
Phonological Awareness
Phonics
Grade Levels
Hourly:
PayPal
Venmo
Cash
Cheque
Scheduling & Cancellation
Any cancellations or schedule changes must be communicated within 24 hours of the scheduled session to receive a refund.
Guardian Signature Required for Students under 18 years old
Student Signature:
Clear Signature
Date:
Guardian Signature:
Clear Signature
Date:
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