Form

Campus *

Student's Name *

First

Last

Grade *

Teacher *

What subject does your child need tutoring for? *

Day(s) Desired *

Number of Hours Desired *

COST: $75 per hour paid to the tutor at the time of tutoring. Checks are to be made out to the school.

NOTE: Without advance payment, the tutor will not be able to tutor. Students who do not show without advanced notification will be charged for the session. Tutors may be notified of absences through the school office. All tutoring must be done on campus after the teacher workday has ended; usually 3:30 pm.

Parent *

First

Last

Mobile Phone *

Email *

Signature *