Student's Grade (if summer, grade student will enter in fall): *
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In-person tutoring at your home or online tutoring? *
The service(s) the student or parent requires are: *
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The student's area(s) of strength are: *
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The student's area(s) for improvement are: *
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If possible, please provide more details about what specifically needs to improve. For example, if you selected "Math" above, what specific math concepts are areas of struggle?
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What feedback has the student's teacher provided regarding what and how to improve? *
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Does the student have any learning differences? If so, please describe. *
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What are the student's interests and hobbies? *
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What are your/the student's goals in receiving tutoring? *
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Is there any other information that you feel the tutor should know?
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I agree that I am contracting Piñon Tutoring LLC by Seth A. Stambaugh to provide tutoring services for a student in the subject area(s) listed on this form for a period of time to be determined by the necessity of the student, by the tutor, or by the client. I have read and agree to Piñon Tutoring's Privacy Policy and Terms and Conditions as listed at: https://www.pinontutoring.com/privacy-policy and https://www.pinontutoring.com/terms-and-conditions. Piñon Tutoring will not be able to offer tutoring services if you select "No." *
Today's Date: *
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Your tutor will review your questionnaire before the first tutoring session to choose appropriate assessments.
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