New Student Registration Form
This form is required for new tutoring students
Sign in to Google to save your progress. Learn more
Student Name *
Student Date of Birth *
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? *
What time of day works best for tutoring? *
How did you find out about us? *
I have read and agree to the Tutoring Policies in the Deep Roots Learning Solutions handbook *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.