Enrollment ApplicationSign your child up for Tots 'N Tutors here.Please enable JavaScript in your browser to complete this form.Child's Name: *DOB: *Date of Birth of ChildHome Address: *Mother's Name:Father's Name:Phone: *Secondary Phone:Email: *Secondary Email:Subjects of concern:GPA:Grade Level:School Name:School District:Tutoring Availability - MondayMorningAfternoonEveningTutoring Availability - TuesdayMorningAfternoonEveningTutoring Availability - WednesdayMorningAfternoonEveningTutoring Availability - ThursdayMorningAfternoonEveningTutoring Availability - FridayMorningAfternoonEveningTutoring Availability - SaturdayMorningAfternoonEveningTutoring Availability - SundayMorningAfternoonEveningDo 1-hour OR 2-hour sessions work?1-hour2-hourBOTH WORKWhat specific hours fit your schedule?Tuition RatesTuition Rates $50/ for all mobile & online sessions (additional fee for travel beyond 25 mile radius from base) ** $45 / hour **Specials and promotional rates All fees must be paid on a daily or weekly basis. Weekly rates must be paid at the first session of the week. I plan on paying with cash:YESNOI plan on paying with a personal check:YESNOI plan on paying with a credit/debit card (PayPal and Square fees apply):YESNOI plan on paying using Cash app, Venmo, or Zelle (fees apply)/(please specify):Cash AppVenmoZelleNone of the above*Reminders for payment after 12 hours of a requested invoice payment will be subject to a 5% administrative fee added to the current invoice.Cancellation Policy (please sign) *A notice must be given 24 hours prior to a scheduled session to be a valid cancellation. The first three canceled appointments that do not meet this requirement will be subject to a minimum charge of $25. Subsequent cancellations will be subject to the full session rate charges. A notice to request cancellation of all services must be given at least 2 weeks prior to avoid session fees.Date signed:Comments or How did you hear about us?I am willing to receive and respond to text and email messages as a suitable form of communication: *YESNOI agree to allow Tots ‘N Tutors to use images for business promotions only on social media, website, and other marketing platforms: *YESNOSubmit