Seeley Test Pros - Student Information
Academic Tutoring 2020
Student Name: *
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Parent Name: *
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Student Phone Number: *
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Parent Phone Number: *
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Student Email Address: *
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Parent Email Address: *
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Student’s Graduation Year: *
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City of Residence: *
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Student's High School: *
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Student's Cumulative GPA: *
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Student would like tutoring for the following subject(s): *
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Student's Current Math Course: *
Student's Current Science Course: *
Student's Current English Course: *
Student's Current Social Studies Course: *
Student's Current Foreign Language Course: *
Does this student take any honors, AP, or IB courses:
What subjects tend to be areas of strength for this student? *
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What subjects tend to be areas of concern for this student? *
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Is this student on an IEP or 504 plan? *
If you answered yes to the previous question, what kind of accommodations do they receive?
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Has this student been referred to Seeley Test Pros by a specific individual? If so, please list their name(s):
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What is the student's current motivation level for tutoring: *
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What style of tutoring would this student benefit most from? *
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Does this student have a preference of gender for their tutor? *
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Do you have a preference for a specific Seeley Test Pros tutor? If so, please check the name below.
When does the student often have availability for tutoring?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
8:00am-12:00pm (During a free period at school.)
12:00-3:00pm (During a free period at school.)
3:00-6:00pm
6:00-9:00pm
Unavailable this day
If during a free period at school, what is the time of day?
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What location(s) could this student meet their tutor? *
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Which tutoring package are you requesting? Payment can be made by cash, check, Venmo or Paypal (5% fee). *
Seeley Test Pros will attempt to accommodate scheduling changes, but only with a minimum of 24-hours notice prior to the scheduled tutoring appointment. Notice must be provided by phone, directly to the instructor. If email and/or text communications of the cancellation are provided, such are only effective upon the receipt and responsive confirmation by the instructor. Cancellations with less than 24-hours advance notice will result in a charge of the full amount of the scheduled time. In the case of inclement weather (e.g., snowstorms) and emergencies, Seeley Test Pros will make a determination on fee waivers for late cancellations due to emergencies. *
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