College Coaching
2020-2021 Registration Agreement
Email address *
Student Name *
Your answer
Gender *
Birthdate *
MM
/
DD
/
YYYY
School Student is Attending and Grade Level *
Your answer
Graduation Year
Your answer
Home Address *
Please include city and zip code.
Your answer
Home Phone Number *
Use dashes to separate. Example: 703-830-7037
Your answer
Student Cell Phone Number *
Your answer
Student Email Address *
To email documents and alert student to any class changes.
Your answer
Special Accomodations
Do any of these apply to your chiild?
Other Information (as needed)
Your answer
Mother's Name *
Your answer
Mother's Address *
Type "Same" if same address as student.
Your answer
Mother's Email Address *
We need more than one "family" email address in the event of invalid or bounced back emails.
Your answer
Mother's Cell Phone Number *
Your answer
Mother's Work Phone Number
Your answer
Father's Name *
Your answer
Father's Address *
Type "Same" if same address as student.
Your answer
Father's Email Address *
We need more than one "family" email address in the event of invalid or bounced back emails.
Your answer
Father's Cell Phone Number *
Your answer
Father's Work Phone Number
Your answer
Billing Name: *
Name of person/people responsible for payment.
Your answer
Billing Phone Number: *
Phone Number of person/person responsible for payment.
Your answer
Billing Address: *
Mailing address or person/people responsible for payment.
Your answer
How did you hear about us? *
Required
College Coaching Packages:
Packages *
Required
Add-On Services
A la carte Services
A Note About A la carte Services and Add-Ons:
A la carte Services may be added to any College Coaching Package at the hourly rate. Payment for A la carte Services is due within 15 days of billing. Payments received after 15 days will be assessed a $25 late fee. Returned checks will be assessed a $35 fee. In the event that Professional Tutoring, LLC does not receive payment within 30 days of its due date, the undersigned Responsible Party will be responsible for all reasonable attorney and administrative fees incurred in the collections process, in addition to payment due. Interest will accrue at 1.5% per month (18% annually) from due date.

Clients may convert to a larger program. Clients who purchase the Go-Getter, All-Inclusive or Elite Applicant Packages may also purchase Add-on Services. Additionally, a la carte services at the rate of $275 an hour can be added to any College Coaching package for clients who need more support.
Disclaimer, Release & Acknowledgements
Registration commits the Student and Parents to the services purchased and full payment of the fee. No Fees will be refunded.

Professional Tutoring, LLC, provides no guarantee that the Student will be accepted into or receive merit or financial aid from the college(s) of choice or that the Student will like any/all of the universities recommended by Professional Tutoring, LLC. Instead, the intent of this coaching service is to provide the framework and resources necessary to assist with college placement activities. In no way is the provider of this service, Professional Tutoring, LLC, liable for any damages or claims in light of non-selection for admission or scholarships or dislike of any college or university. Substitutions of service deliverables are not permitted in the Professional Tutoring College Coaching Packages.

Professional Tutoring, LLC employs a number of professional staff and different staff members may work on a Student’s College Coaching services.

I authorize Professional Tutoring, LLC, to use any work completed by my student (or myself if over 18 years old) as part of the Professional Tutoring College Coaching process, as well as any photos taken of my student (myself) during that process, in furtherance of the business of Professional Tutoring, LLC, including, but not limited to, brochures, marketing, and social media.

I acknowledge receipt of Professional Tutoring’s College Coaching Notes and Requirements. I understand and agree to work within the guidelines and Final Deadlines specified in the College Coaching Checklist. I understand that missing Professional Tutoring Final Deadlines may forfeit applicable services. Any deadline extension requests must be submitted in writing before Final Deadlines with justification to Professional Tutoring, LLC for Professional Tutoring’s consideration. Professional Tutoring, LLC reserves the right not to extend deadlines.

I acknowledge that I have read this Agreement and understand the nature of the services to be rendered and the applicable fees. I further acknowledge that I have been afforded the opportunity to discuss any questions about the terms of this Agreement before signing below.
Signature *
Please type in your NAME to agree to the Terms and Conditions of this Agreement. By typing your name here and selecting the "Submit" button at the end of this form, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "Submit" you consent to be legally bound by this Agreement's terms and conditions. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and Professional Tutoring. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement. Thank you.
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