Orton Gillingham Tutoring

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Email *

Today's Date *

YYYY

Name *

Preferred Name (or nickname you would like the tutor to call the student)

Age *

Grade (if applicable) *

Birthdate *

YYYY

Email address to be used for Communication *

Phone number *

Do you have or are you willing / able to use Zoom? *

Yes

Other:

Do you have the ability to print things I might email for sessions? *

Yes

OG tutoring is a multi-sensory method, so having some hands-on materials are important. Are you willing to get some sensory object for the student like some sand or rice in a flat container or dish, some various writing utensils like a red pen, highlighter, etc and perhaps a small white board and markers or other little materials as tutoring progresses? *

Yes

Are you willing to make a 30 session commitment? This question does not apply to Summer session. *

Yes

I am signing up for summer tutoring, so this question does not apply.

Other:

OG Tutoring works best with 2 sessions per week. Will this work for you? (If not, please note what will work under "Other") *

Yes

Other:

What days (and what times on those days) would work for you? *

What time zone are you in? *

Are you willing to pay using Zelle?

Yes

I would prefer to pay by CC or ACH using Autopay (This option includes a 4% service charge.)

Option 3

How did you come to this form? (Friend referred, Google search, Advertisement, Facebook Group, etc.) *

Submit

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