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Individual Academic Tutoring Registration

Academic Tutoring Form

Please complete the following form so that we may get started with your student. We look forward to helping your student grow in both academic confidence and skills!

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Contact Info
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Your Name*
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Phone Number*
Please provide the best contact number should there be an issue with your registration.
Student Information
Student's Name*
First Last
Is your student in high school or middle school?*
- High School
- Middle School
High School*
Enter High School*
High School Graduation Year*
Enter Middle School Name & Current Grade*
Enter Graduation Year*
For what subjects is your student requesting tutoring?*
- Geometry
- Algebra II
- Algebra II Honors
- Algebra II/Trig
- Precalculus
- AP Precalculus
- Math Analysis
- Calculus (non-AP)
- AP Calculus AB
- AP Calculus BC
- AP Statistics
- AP Biology
- AP Chemistry
- Physics
- Biology
- Chemistry
- AP U.S. History
- AP World History
- AP Government
- Economics
- Philosophy
- AP Literature
- AP Language
- Honors and Academic English
- Dual Enrollment Classes
- College Essay Writing
Please list the current grade your student has earned in class chosen above.*
When would you like to begin?*
Please describe here:*
Has your student participated in any tutoring programs in the past?*
- Yes
- No
Please list company name or person, along with rough dates of previous tutoring.*

More Info About Your Student
Does your student have learning differences (e.g. ADD/ADHD)?*
- Yes
- No
Please describe what type of learning differences (e.g. ADD/ADHD) and any other information you'd like to share.*
Does your student have established accommodations for standardized tests?*
- Yes
- No
Please describe the accommodations such as extra time for exams.
Does your student have any food allergies, medical issues, or learning disabilities about which we should be aware.*
- Yes
- No
Please describe why you answered YES above.*

How did you hear about Loudoun Test Prep?
(Optional) We'd love to thank thank them. Can you provide the names?
Comments/Questions

Acknowledgement Section
In this next section, we ask you to acknowledge and accept some of the important points of our program that people often overlook, but are critical to a successful relationship going forward.
Scheduling, Payments & Refunds, Logistics, and Publicity Policies
I have read and accept the LTP provisions, policies, and Cheating Policy outlined in the LTP General Logistics and Expectations page.
*
- I accept
Cancellation Policy
Loudoun Test Prep makes reasonable efforts to adjust to the hectic schedules of our clients, but only if notice of cancellation is received at least 24-hours in advance of the scheduled appointment or tutoring session. Cancellations with less than 24-hours advance notice will result in a charge of the full amount of the scheduled time or session.
- I accept
Homework and Binders
I understand that homework is a critical part of this course and I will ensure that my student is completing his/her homework for and bringing the course binder to every class.*
- I accept
Billing
I understand how billing works for Individual Academic Tutoring, and I have reviewed the link below. In addition, I understand that payments may be made via credit card or Venmo only.*
- I accept
Please read our Individual Academic Tutoring billing policies..
Non-Solicitation
Loudoun Test Prep tutors are not to be solicited for hire as tutors outside of this agreement. Each tutor signs a non-compete agreement when they are hired at Loudoun Test Prep.
I understand and accept the provisions and policies in LTP's Logistics and Expectations page including the Cheating Policy.*
I accept*
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