HOURLY TUTORING CHILDS DETAILSFirst Name *Last Name *Date of Birth *ID Number *Grade *Age *Gender *MaleFemalFATHER / GUARDIAN DETAILSFirst Name *Last Name *Date of Birth *ID Number *Phone *Email Address *Street Address *City *ZIP / Postal Code *MOTHER / GUARDIAN DETAILSFirst Name *Last Name *Date of Birth *ID Number *Phone *Email Address *Street Address *City *ZIP / Postal Code *BILLING INFORMATIONPlease Note that upfront payment of 4 Weeks are required for Hourly Tutoring.Is person responsible for payment of fees different from parents /guardian? *YesNoFirst Name *Last Name *Date of Birth *ID Number *Phone *Email Address *Street Address *City *ZIP / Postal Code *SIGNATURESPARENTS / GUARDIANFirst Name *Last NameID Number *Date Signed *Signature *Consent *Yes, I agree with the terms and conditions.TUTORING SESSIONS NEEDEDPlease Select the Amount of Hourly Tutoring Sessions Needed for a WEEK *1 Hour2 Hours3 Hours4 Hours5 Hours6 Hours7 Hours8 Hours9 Hours10 HoursR 100 Per HourTotal For 4 WeeksRSend Message
