What grade is your student in for the 2022-2023 Academic Year?
Choose
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
Student School District: *
Which school district will your student attend in the 2022-2023 Academic Year?
Choose
Pleasanton Unified School District
San Ramon Unified School District
Dublin Unified School District
Other
If you selected "Other," please let us know what School District your student goes to:
Your answer
Student School: *
Which school will your student attend in the 2022-2023 Academic Year?
Your answer
Is your Student First-Time Enrolling or Returning? *
First-time enrollment has a one-time mandatory new student enrollment fee of $20
Gender: *
Parent First Name: *
Include the name of the parent who is the preferred point of contact regarding this student.
Your answer
Parent Last Name: *
Include the name of the parent who is the preferred point of contact regarding this student.
Your answer
Parent Preferred Title: *
Main Contact Email Address: *
Please use the email you would like us to use for communications. If you would like to add a second email, please fill out below.
Your answer
Secondary Contact Email Address:
If you would like to add a second email address to be included in communications, please do so here.
Your answer
Preferred Primary Phone Number: *
Please include your preferred phone number for communication regarding this student.
Your answer
Alternate Phone Number:
If you would like to include an alternate phone number, please do so here
Your answer
Emergency Contact Name: *
Please include your Emergency Contact's First and Last name.
Your answer
Emergency Contact Phone Number: *
Your answer
Home Address: *
Your answer
What is your class format preference? We are planning for a hybrid format, however that is subject to change at any time based on CDC/federal/state/local rules. *
Referred by?
If you were referred to Summit by someone who was previously a student here, please include the student's full name here. Referrers will receive a $20 credit towards their next tutoring if the referred student stays with STC for at least one session.