New Student Registration Form
This form is required for new tutoring students
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Student Name *
Student Date of Birth *
MM
/
DD
/
YYYY
Current Grade in School *
Does your child currently receive any tutoring or learning support services, such as specialized instruction at school through an IEP, or other tutoring? Please describe. *
Parent Name(s) *
Parent Email *
Phone number *
Phone Type *
Which way do you prefer to be contacted for appointment reminders? *
What days work best for tutoring? *
Required
What time of day works best for tutoring? *
Required
How did you find out about us? *
I have read and agree to the Tutoring Policies in the Deep Roots Learning Solutions handbook *
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