New Family/Student Signup
Thank you for registering with Focus Tutors. Please fill out this form
completely
, so that we may provide you the best service possible.
Parent Information
First Name*
Last Name*
Email*
Mobile Phone
Home Phone
Address*
Address Line 2
City*
State*
Zip*
Preferred Contact Method
Email
Text
Phone Call
How did you hear about us?*
We require a credit card on file to ensure prompt payment of all tutoring services. Each month you will have the opportunity to pay via check or credit card. If payment is not received by 14th of the month following services rendered, the card on file will be charged for the full amount due.*
Student Information
First Name*
Last Name*
Email
Mobile Phone
Birth Date*
Grade*
School*
Please select all potential services.*
ACT-Math
ACT-Verbal
ADD/ADHD Coaching
Algebra I
Algebra II
Biology
Calculus
Chemistry
College Algebra
Economics
EF Coaching
Elem-Math
Elem-Reading
Elem/MS-Writing
French
Geometry
HS-General Homework & Organization
HS-History
HS-Language Arts
HSPT Individual
Kindergarten Readiness Evaluation
MS-General Homework & Organization
MS-Language Arts
Online Learning Support
Physics
Pre-Algebra
Pre-Calculus
PSAT
SAT-Math
SAT-Verbal
Spanish
SPED
Trigonometry
What are your goals with our services?
What are your child's academic strengths?
Include any additional information that would be helpful for us to know when working with your child.
How many hours of tutoring per week is your goal? *
Select
1
2
3
4+
What are your preferences for tutoring: In-Person, Online or Both?*
In-Person
Online
Both
List all times your child is available to meet (example: Monday 3:00-6:30).*
Teacher Contacts
Teacher Contact 1
Subject 1
Email 1
Teacher Contact 2
Subject 2
Email 2
Teacher Contact 3
Subject 3
Email 3
Remove
Add Fields for Additional Student
Submit
