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Eurekii Tutoring Interest Form
Thank you for your interest in coming to Eurekii! We look forward to meeting you and your student. Plesse complete the 2-minute form below. Once submitted, we'll contact you to setup a free assessment!
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1. What's your first name? (parent/guardian)
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Your answer
2. What's your last name? (parent/guardian)
*
Your answer
3. What is your student's first name? (child)
Your answer
4. What is your student's last name? (child)
Your answer
5. What's your email address?
*
Your answer
6. What phone number can we use to contact you?
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Your answer
7. What grade level is your student?
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Choose
Pre-K - Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
High School
College
8. For what subject(s) is your student seeking tutoring?
Mathematics
English/ Reading
Science
ISEE Prep
SAT Prep
Test Prep (Other)
Other:
9. What specific goals do you have for your student?
Improved grades
Increased confidence
Enrichment - Push a well-achieving student to a higher level
Increased test score (ISEE, SAT, Etc.)
Summer Teaser (Special 4 session offer over break!)
Other:
10. Is there anything else we should know about your student? Any special hobbies or interests?
Your answer
11. Do you have a coupon code? Enter it below!
(Leave blank if not)
Your answer
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