A+ Program Tutoring Application Form   A+一对一私教报名表
*Only for those who don't fill in paper forms
【如已填写纸质报名表，无需重复再填】

Main Office: 1106 Commonwealth Ave. Boston, MA 02215 Tel: (617) 730-3705 Fax: (617) 730-3700

Chinatown Office: 65 Harrison Ave. 6th FL Boston, MA 02111 Tel: (617) 338-5288 Fax: (617) 391-0255

Please fill and sign this form out, and email it to info@aplusprogram.com thank you

Student application fee per subject $50 (non-refundable) 单学科报名费(不可退款)$50
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Student Status 学生状态 *
Program Choice: 时间选择
Clear selection
Student’s Name 学生姓名
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Sex 性别 *
Date of Birth 出生日期
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MM
/
DD
/
YYYY
Current Address 住址
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Zip code 邮编
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Email Address 电子邮件
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Guardian's Name 家长姓名 *
Guardian's Phone Number 家长电话
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Emergency Contact Name 紧急联系人姓名
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Emergency Contact Number 紧急联系人号码
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Name of School Attending 现就读学校
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Grades before September 9月前就读年级 *
Where did you hear about Academic Student Center? 您从何得知 ASC A+ Program 的？
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Subject Area of Study:  私教学科
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Required
Test Prep?  考试准备?
Previous Test Scores 考试成绩
Test Date 考试日期
MM
/
DD
/
YYYY
YOUR GOALS for this tutoring 辅导目标
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Will the tutor be helping with HOMEWORK? 老师辅导作业吗？
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Do you have your own materials/books? 自备材料吗？
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Preferred Days 补课日期
 *
Required
Preferred Times 补课时间
Time
:
Study Location 上课地点
 *
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