Registration Form
Submit 1 Registration Form for each student

12 Week Program

2 Classes/Week

1hr 30min each Class

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Email *
Parent/Guardian Name ( First Last ) *
Contact Phone Number ( XXX-XXX-XXXX ) *
Student's Name ( First Last ) *
Grade *
Most Recent Math Grade *
Name of the School Student currently attends? *
Race *
Does the student know the Multiplication Tables *
Required
Please select the days when the student is available for tutoring. (you can select more than one) *
Required
Please select the times when the student is available for tutoring. (you can select more than one) *
Required
Do you prefer individualized one-on-one tutoring or participating in group classes with other students?  *
Note: The pricing will vary between one-on-one tutoring and group classes.
A copy of your responses will be emailed to the address you provided.
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