JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2024-25 School Year Online Tutoring Registration Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student's name:
*
Your answer
Student's grade:
*
Your answer
School Board:
*
Your answer
School:
Your answer
Student's date of birth:
*
MM
/
DD
/
YYYY
Parent/Guardian name(s):
*
Your answer
E-mail address:
*
Your answer
Cell phone:
Your answer
Home phone:
Your answer
Business phone:
Your answer
Desired program(s):
*
Reading
Comprehension
Writing
Spelling
Mathematics
French
Other:
Required
Desired number of session/week:
*
Your answer
Desired tutor:
Your answer
Select all of the days/times that will work for you, both on weekdays and weekends
Desired weekday start time:
1:45pm
2:30pm
3:15pm
4:00pm
4:45pm
5:30pm
6:15pm
7:00pm
7:45pm
Monday
Tuesday
Wednesday
Thursday
Friday
1:45pm
2:30pm
3:15pm
4:00pm
4:45pm
5:30pm
6:15pm
7:00pm
7:45pm
Monday
Tuesday
Wednesday
Thursday
Friday
Desired weekend start time:
10:00am
10:45am
11:30am
12:15pm
1:00pm
1:45pm
2:30pm
3:15pm
4:00pm
4:45pm
5:30pm
Saturday
Sunday
10:00am
10:45am
11:30am
12:15pm
1:00pm
1:45pm
2:30pm
3:15pm
4:00pm
4:45pm
5:30pm
Saturday
Sunday
Additional comments:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dr. Clark's Reading Centre.
Report Abuse
Forms
