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Student First Name*

Student Last Name*

Student Email

Student Phone Number

Name of Current School/College*

Graduation Year*

Parent First Name*

Parent Last Name*

Parent Email*

Best Phone Number to Reach Parent *

Address*

Address Line 2

City*

State*

Zip*

How did you hear about us?*

If other, please put how you heard about us here:

Whom can we thank for recommending us?

How can we help your child? *

If other, please put how we can help your child here:

When do you want to start?*

When do you want to end? *

If other, please pick an end date

Do you prefer:*

First Choice (For example, Tuesdays 4:00-7:00) *

Second Choice*

Third Choice*

Fourth Choice*

One of the benefits of our college counseling packages is priority scheduling. Is your child an Apt college counseling client?

Please describe your child's learning style, hobbies and interests. Does a learning difference, ADD/ADHD or health issue impact your child's learning?

What academic subjects and level (college prep, honors, AP, college) would you like tutoring for?

TEST PREP: INDEPENDENT SCHOOL EXAMS

ISEE

HSPT

SSAT

Not sure

TEST PREP: SAT/ACT

For the SAT, does your child need help with:

For entire SAT

Please let us know which test dates your child is considering taking. Check all that apply:

If other, please pick a date:

For the ACT, does your child need help with:

For entire ACT

Check all that apply:

If other, please pick a date:

Please let us know your scores below or email us an attachment to hello@apttutoring.com. If possible, specify the score for each section.

How much SAT/ACT homework can we reasonably give your child each week?

If other, please indicate how much homework we can give your child each week:

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