2020 Midterm Exam Tutoring Request & Spring 2021 Return to Tutoring Form

Student Name:*

First Last

Parent Name:*

First Last

Parent Cell:*

Email:*

Address:*

Zip Code*

School:*

Grade Level:*

Year of High School Graduation:*

Subjects/Topics for MidTerm Tutoring:*

Please List MidTerm Exam Schedule (including times, if applicable):*

Desired Dates for MidTerm Exam Tutoring*

Please select the local branch to which sessions will be delivered*

Daily Availability

Please list the time range your student is available to be tutored each day below. If they are not available, type "N/A."

Friday, December 4*

Saturday, December 5*

Sunday, December 6*

Monday, December 7*

Tuesday, December 8*

Wednesday, December 9*

Thursday, December 10*

Friday, December 11*

Saturday, December 12*

Sunday, December 13*

Monday, December 14*

Tuesday, December 15*

Wednesday, December 16*

Thursday, December 17*

Friday, December 18*

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Preferred Method of Tutoring Delivery

In-Person
Virtual Tutoring in our Online Classroom
Either

Desired Start Date:*

Preferred Tutor:*

Are you open to a substitute tutor if your preferred tutor is not available on a particular date requested?*

Yes
No

Please select the preferred gender for the substitute tutor:*

Male Only
Female Only
Open/No gender preference

Top 3 Tips to Teach Your Student Effectively:*

1)	2)	3)

Date of Last Session to Occur in 2020*

Date for Tutoring to Resume in Spring 2021*

2020 Midterm Exam Tutoring Request & Spring 2021 Return to Tutoring Form

Daily Availability

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