Online Forms

Εmergency Form

STUDENT'S NAME: *

First

Last

By typing your name both parties agree that it counts as a legal signature. Both parties agree this agreement may be electronically signed. The parties agree that the electronic signature appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.

AGE: *

BIRTH DATE (mm/dd/yyyy): *

GRADE: *

ADDRESS: *

STUDENT'S EMAIL *

PARENT'S NAME (GUARDIAN): *

First

Last

CELL PHONE: *

EMAIL ADDRESS *

WOULD YOU LIKE TO BE ADDED TO OUR REMIND TEXT THREAD/ MAILING LIST

Yes
No

*THIS THREAD WILL BE USED TO REMIND YOU ABOUT PERIODIC CLOSURES FOR HOLIDAYS, SCHEDULING UPDATES, OR REMINDERS ABOUT IMPORTANT UPCOMING PROGRAM EVENTS*

PLEASE DISCLOSE ANY SPECIAL NEEDS, OR LEARNING DISABILITIES THAT YOUR CHILD MAY HAVE:

We ask that you call Tutor Zone by 1p.m. on the day of your child's session if they are going to miss. Failing to call before 1p.m. will result in a $15 fee and failing to call or show to your scheduled appointment will result in a $35 fee. I agree *

Yes

Name *

First

Last

By typing you name, both parties agree that this agreement may be completed electronically. The parties agree that a typed name appearing on this agreement is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.

Date (mm/dd/yyyy): *

If you prefer to fill out the forms on paper, check the box below.

In-person at a location
By mail

Deposit Options *

$100 cash/check deposit (must be submitted before the 2nd session)
Credit card on file

Payment Agreement Tutor Zone does not require our customers to pay in advance or sign a service contract; however with the high volume of students we ask that each customer place a credit card on file or a $100 cash/check deposit as an alternative. If at any time the account balance exceeds $70, the balance will be deducted from the agreed upon deposit. If the cash/check deposit is not used, it will be returned upon termination of services.

Payment Period *

Weekly
Bi-weekly
Monthly

Form of Payment *

Check/Cash
Credit Card
Zelle
Email Invoice

Name (parent/guardian) *

First

Last

By typing you name, both parties agree that this agreement may be completed electronically. The parties agree that a typed name appearing on this agreement is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.

Email *

Today's date (mm/dd/yyyy) *

If you prefer to sign the forms on paper, choose the best option below

In person at a location
By mail