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Thank you for your interest in 1 On 1 Academic Tutors! To be matched with an expert tutor or learn more, please call our office at (866) 918-8867 or fill out the Registration Form below. A credentialed teacher will call you back within one business day to discuss your needs and help you get started.

Student Information (All fields are required.)

• Student Name:

• Sex: Male  Female

• Date of Birth:

  Age:

• School:	Grade:
  Subject(s) to be Tutored:	# of Hours per Week:

• Availability for Scheduling (please indicate specific times available for each day): (Optional but recommended)
• Monday:
• Tuesday:
• Wednesday:
• Thursday:
• Friday:
• Saturday:
• Sunday:

Parent Information (All fields are required.)

• Parent/Guardian Name:

• Home Address:

• City:

  State:

  Zip:

• Email:

• Phone:

Additional Parent Information  

• Parent/Guardian Name:

• Home Address:

• City:

  State:

  Zip:

• Email:

• Phone:

Additional Information

The following questions are optional and your responses are kept confidential. This information helps us to better match your child with a tutor based on his or her specific needs and interests. Please be as detailed as possible and feel free to leave questions blank that you feel do not apply.

• Does your child have any allergies?

  Yes

  No



• If yes, allergic to:

• Does your child have any (diagnosed or observed) medical, behavioral, or learning concerns we should be aware of? Please describe so that we can best meet your child’s needs. (optional)

• What are your child’s current grades in school? If your child’s school does not have grades, tell us what you know about his or her standing in different subjects. (optional)

• What do teachers say? What have you observed about how your child learns best and his or her areas of strength and struggle? (optional)

• What is your child like? What are his or her interests outside of school? Please describe your child’s personality and hobbies. (optional)

• On a scale of 1-10, how would you rate your child’s organization and study skills? Please elaborate. (optional)

Please describe your child’s attitude toward school.(optional) Please describe your child’s attitude toward reading. How much does your child read? What type of books does he or she enjoy? (optional) Please use this space to include any other information you feel would be helpful to us, or to continue any answers above. (optional)

• How did you hear about us? (optional)

• Would you like to receive updates about our special offers and programs?

  Yes

  No

Private Tutoring Agreement

• Please read over the following.

  Scheduling:

  1. Your tutor will call you to introduce herself, and to set up the first session at a convenient time for both of you. The tutor will also email you her contact information and a confirmation of the first session.
  2. Any make-up sessions, cancellations, or extra sessions can be coordinated directly between you and your tutor. Please keep your tutor’s contact information on hand in case you need to get in touch.
  3. The minimum session length is one hour, even if the duration is less than one hour. For high school courses or test prep, we recommend two hour sessions.
  4. There must be an adult home at all times. Tutors are not allowed to stay home alone with students under the age of 18 in case of an emergency.
  5. We highly recommend setting up a regular weekly schedule with your tutor. This helps ensure that your tutor will be available when needed.

  Billing & Payments:

  1. At the end of each session, we require that you initial your tutor’s time sheet, thus authorizing us to charge you for the session time. We bill in quarter hour increments after the first hour (e.g. 1 hour and 45 minutes would be recorded as 1.75 on your tutor’s time sheet).
  2. Students (under 18) may not initial their own time sheet. A parent letter must be provided if you would like to authorize your child to sign on your behalf at the end of each tutoring session.
  3. All tutoring hours will be paid for at the end of each month. Your card on file will be charged for the hours you initialed. Once the charge is made, you will receive an email receipt.
  4. All billing is handled through the office. If you have a question regarding billing, or need to update your payment information, please contact the office directly (rather than your tutor).
  5. If you prefer to pay by check, you will receive an invoice for the total amount due. We ask that you kindly send remittance by the due date noted on the invoice. Please note, you will incur a $35 late fee for past due payment and a $25 service fee for any returned checks. 6. Your tutoring session begins when the tutor arrives, and it ends when you have initialed your tutor’s time sheet. Tutors are happy to stay with you an extra five minutes to debrief about the session at no additional charge.

  Refunds for Packages:

  1. Any unused hours are non-refundable; however, hours can be used at any time and are transferable to family and friends.

  Cancellation:

  1. Please contact your tutor directly about any cancellation or schedule changes.
  2. We ask that you kindly notify your tutor 24 hours in advance of a cancellation to avoid a one hour penalty charge.
  3. If an adult is not present when the tutor arrives, the tutor will wait for twenty minutes and attempt to reach you by phone. After twenty minutes, the session will be considered a “no show” and charged as one hour.
  4. We know that your time is valuable. Should your tutor cancel the same day, or end a session prematurely, we will compensate you one free hour of tutoring.
  5. Please contact the office if you would like to suspend tutoring services, or if you would like to discuss your tutor.

  Miscellaneous:

  1. I agree to pay the entire amount due to 1 On 1 Academic Tutors by the due date each month.
  2. I will never contract with tutors separately for tutoring services, as this is a violation of 1 On 1 Academic Tutors’ terms of service.
  3. I understand that all pay for tutoring services must be made to 1 On 1 Academic Tutors, and not to the tutors themselves.
  4. An adult will be at the tutoring location for the entire duration of the tutoring session.

  We are truly committed to our students and their academic success. Please find comfort knowing that we will work with you to find the best solution if you are not 100% satisfied. We welcome any questions or concerns you may have. Thank you.

• I have read and understand the above agreement and agree to its terms (required)