SHOREICAN Child Services Client Interest Form

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Thank you for your interest in our services. Please submit this form and a tutor will contact you in the next 24 to 48 hours. For more information about SHOREICAN, please see the following links:
http://shoreicanchildservices.com/
https://m.facebook.com/ShoreICan07753/?ref=bookmarks

Email *

I am interested in scheduling a Meet in Greet with the following tutor:

I am interested in an academic evaluation?

Yes

I'd like more information about academic evaluations

Clear selection

I would like to schedule a meeting with an advocate:

Yes

Maybe

Clear selection

Name (first and last):

Phone Number:

Type of Tutoring Service:

Reading

Math

Other:

Clear selection

Child's Name (first and last):

Child's Grade:

Type of Tutoring:

Virtual

In-home

Clear selection

School District:

Submit

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