TUTORING SERVICE      REGISTRATION FORM

(When the form is filled out, please click SUBMIT button at the bottom of the form.)

Student’s Name:

School and Grade:

Which option below fits the academic need of your child? (choose only one option and check):

   Option I:    Saturday Math(10:30AM-12Noon)         Monday English (3:30PM-5PM)

    or,

   Option II:  Saturday English (10:30AM-12Noon)    Monday Math (3:30PM-5PM)                                                                      

Parent/Guardian Name(s):

Address:

                            (Street)                                                        (City)              (Zip code)

E-mail:

Phone No:

Comments/Additional Information:

Parent/Guardian Signature: Date