Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Tutoring & Reinforcement
Location: Public Library
Contact us at 585-378-9988
Email: marisa@marisalaurenwellbeing.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name of Child
*
Your answer
Grade
Your answer
Parent Email
*
Your answer
Parent Phone Number
*
Your answer
What days are best for you?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Other:
Required
What times are best for you?
Morning 9:00 am - 11:00 am (August only)
Afternoon 2:00pm - 5:00pm
Evening 6:00pm - 7:00pm
Clear selection
Please share a bit about your child example, grade, skills and what your child needs tutoring/reinforcement in.
Your answer
Does your child hold an IEP or a 504 plan? Please explain or write N/A if not.
Your answer
I understand I can pay $60/hr via zelle, venmo or cash on the day tutoring takes place or before. Please let us know if there is a financial hardship and we would be happy to discuss.
I understand if I do not cancel the tutoring session within 3 hours, I am still responsible for payment.
*
Yes
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report