1-on-1 Tutoring Enrollment Form
This form is for students wishing to enroll in our tutoring program. Please contact edrisetutoring@gmail.com with any questions.
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Student's Name *
Parent's Name *
Parent Email Address *
Phone number *
Student email address (optional)
Other email address (optional)
School *
State *
Grade *
Which subjects would you like tutoring in? *
If the student is learning English as a second language, is there another language in which you might prefer sessions to be taught? If so, please specify.
We have a variety of tutors that speak multiple languages, and based on availability we may be able to provide native language-specific support.
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Which days and times work best for the student to be tutored? (Sessions are up to 1 hour long, once a week, at the same time and day each week. All times below are in Pacific time)
2:30 - 3:30 PM
3:00 - 4:00 PM
3:30 - 4:30 PM
4:00 - 5:00 PM
4:30 - 5:30 PM
5:00 - 6:00 PM
5:30 - 6:30 PM
If another time works better, please place it down below (must be within 2:30 - 6:30 time frame):
Does the student have special needs or have an IEP? If so, please specify which condition(s). *
We may not be able to cater to students with unique learning needs at this time; however, we are in contact with other opportunities for special needs students that we can let you know about if we feel that EdRise is not a good fit for your child.
Does your household qualify for free or reduced school lunch, or have you been significantly financially impacted by COVID-19? *
How did you hear about EdRise? *
Have you read and agreed to our Terms and Privacy Agreement? *
The document can be found at https://www.edrisetutoring.org/more/terms.
Additional questions/comments? (optional)
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