Tutoring Intake Form

Tutoring policies

Payment must be made before the start of the sessions by e-transfer.
There is a no refund policy for all services. We do not adjust for sick or vacation days.
Client must cancel 24 hours prior to session, if not client will be charged for the full session.
Sickness- Please keep your child home if they are sick. We can try to accommodate by doing a Zoom lesson.

General Information

Student Name

First Name

Last Name

Guardian Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

School Information

Age

Grade:

Name of School

Learning Assessment

In your opinion what is your child struggling with in reading?

What does your child’s teacher say about their reading?

Is your child’s reading affecting their confidence? If so, how?

What are your expectations for tutoring?

Learning style

What are some learning challenges/strengths your child has?

Does your child have a diagnosis that affects their reading?

What is your child's personality and interests?

Scheduling Preferences

Available date to begin:

Days and times that work best:

We are only open during school hours, therefore your child will need to be pulled from school. Are you willing to accomodate for this?

Yes

How many times a week are you interested in? Please note that your child may need 2 or more times a week depending on assessment results.

When you submit information to this website, we collect the data requested in the webform in order to track and respond to your submissions. This information is stored by Squarespace and Google to provide services to this website.

I agree

Waitlist

I understand that by submitting this form, my child will be added to the Soaring Readers waitlist and I will be contacted as soon as a spot becomes available.

I agree