A-HTS® Returning Student Form

Student's Name*

First Last

Student's Text Number

Parent/Legal Guardian*

First Last

Parent/ Legal Guardian Cell*

Parent/Legal Guardian Email*

Tutoring Address*

City*

Zip Code*

Current School*

Grade Level*

Year of High School Graduation*

Preferred Method of Tutoring Delivery:*

In-Person
Virtual Tutoring in our Online Classroom
Either

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

Austin
Boston
Dallas
Denver
Fort Bend County
Greater New Orleans
Houston
The Woodlands: Kingwood/Humble/Spring

Please List Some Academic Goals for Your Student*

Type of Tutoring (Can Select More Than One)*

Academic Subject Tutoring
College Admissions/Career Advising
Diagnostic and Skills Assessment
Executive Functioning/Academic Coaching
Test Preparation Tutoring (ACT, SAT, or other)

Please note: Test Preparation Services are delivered online/virtually ONLY.*

I acknowledge the statement above.

Please note: Executive Functioning/Academic Coaching Services are delivered online/virtually ONLY.*

I acknowledge the statement above.

Please specify which exam*

ACT
SAT
ISEE
Other

Please specify which level:*

Primary: Admission for grades 2-4
Lower Level: Admission for grades 5-6
Middle Level: Admission for grades 7-8
Upper Level: Admission for grades 9-12

Test Preparation Acknowledgment*

Yes

By Selecting "Yes" to the field above I agree to be charged a $199 annual per license fee for the ISEE program (if preparing for an ISEE exam).

Subjects for tutoring*

Are You Interested in Your Student Taking a Skills Assessment?*

Yes
No

Skills Assessment Acknowledgment*

Yes

By Selecting "Yes" to the field above I agree to be charged a $99 annual per license fee.

Does Your Student Already Have an Exact Path Account?

Yes
No

Ideal Days/Times For Sessions*

Days	Times	Duration

Total Open Days (outside above times)*

Days	Times	Duration

Include any activities to take into account when scheduling, if applicable. Please include practice schedule: (sports, play rehearsals, etc.)

Desired Start Date

Tutor Gender Preference*

Female Only
Male Only
Any

Preferred Tutor (Name):

Tutor Personality Preference (May Select More Than One)*

Calm/Reserved
Outgoing
Willing to Move at a Fast Pace
Willing to Move at a Moderate Pace
Detail Oriented
Results Oriented
Funny/Good Sense of Humor
Firm But Kind

Top 3 Tips for Teaching Your Student Effectively*

1)	2)	3)

Special Notes (if any)

If tutoring is for test preparation (ISEE/ACT/SAT), please upload any previous test scores here

Accepted file types: jpg, pdf, Max. file size: 200 MB.

Official Testing Date(s)

Date*

Covid-19 Policy*

The health and safety of our students and tutors has been paramount while we all navigated the consequences of the pandemic.

As guidance from local, regional, and federal authorities appears to recommend that mask-wearing, disinfecting and social distancing be reconsidered especially with vaccinated parties, we are formulating a new safety approach.

For in-person sessions, we are asking each student-tutor pairing to communicate with each other and arrive at a mutually agreeable decision about whether both parties wear a mask or not, stay socially distanced within the session and what disinfecting procedures, if any, should be used.

Please inform the office should you have any issues or questions.

By checking this box, I acknowledge that I have read and understood the information above.

Please Enter Your Child(ren)'s First and Last Name

On Behalf of Minor Child(ren)*

First Last

Acknowledgement*

By checking this box, I acknowledge that I have read and understood the information above.

Please enter your zip code for our service offerings in your area:

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