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Student Information

First name*

Last name*

Email*

Phone*

Grade*

Date of Birth*

Attending School Name*

Does the student have any learning difficulties or special requirements?*

Yes

No

If yes, please specify

Preferred Tutoring Schedule

Available hours:

Monday to Friday: 3:00 pm to 9:00 pm

Saturday: 11:00 am to 3:00 pm

(Please mention preferred days and times)

Monday*

Tuesday*

Wednesday*

Thursday*

Friday*

Saturday*

Subjects Required

(Check all that apply)

Select subjects*

Gr 9 & 10 Math

Gr 9 & 10 Science

Function

Advanced Functions

Calculus & Vectors

Data Management

Physics

Chemistry

Biology

English (Concepts & Essay)

IB-MYP Math

IBDP Mathematics (AA)

IBDP Mathematics (AI)

IB-MYP Physics

IBDP Physics

Curriculum to Follow*

Mention which curriculum your child follow; State curriculum (Mention state as well) or IB etc.

Any specific goals or areas of focus for tutoring?

Parent or Guardian Information / Emergency Contact Details

If you are 18 or older, you may enter your details or any other person you'd like to have on file as you emergency contact details

Full Name*

Relationship to student*

Email*

Phone*

I confirm that the information provided is accurate to the best of my knowledge.

I agree to the Terms & Conditions of Booking, Refund & Cancellation Policy

Read Terms & Conditions of Booking, Refund & Cancellation Policy

Student Information Form

Call

905-691-7793

Email

info.pacific.tutorials@gmail.com

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