TLC Tutoring Company Online Registration

Registration

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Welcome to TLC Tutoring Company! We are so excited to help your family achieve its academic goals. Please complete the following registration form to get started!

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Contact #1

Parent/Guardian #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Parent/Guardian #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Preferred Tutoring Days/Times?

Tutoring Subject(s) Needed?

Approved Pick-up Contacts

Please use the Search button to see available group classes at our centers. If you are registering for private tutoring, please leave this sessions blank and we will match you to a tutor.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Preferred Tutoring Days/Times?

Tutoring Subject(s) Needed?

Approved Pick-up Contacts

Please use the Search button to see available group classes at our centers. If you are registering for private tutoring, please leave this sessions blank and we will match you to a tutor.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Preferred Tutoring Days/Times?

Tutoring Subject(s) Needed?

Approved Pick-up Contacts

Please use the Search button to see available group classes at our centers. If you are registering for private tutoring, please leave this sessions blank and we will match you to a tutor.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Preferred Tutoring Days/Times?

Tutoring Subject(s) Needed?

Approved Pick-up Contacts

Please use the Search button to see available group classes at our centers. If you are registering for private tutoring, please leave this sessions blank and we will match you to a tutor.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Preferred Tutoring Days/Times?

Tutoring Subject(s) Needed?

Approved Pick-up Contacts

Please use the Search button to see available group classes at our centers. If you are registering for private tutoring, please leave this sessions blank and we will match you to a tutor.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Registration

Referral Information

Family Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

(Show-Hide Details)