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Registration Form
Students Full Name
Parents Name
Current School
Address
City
State
Zip Code
Male or Female?
Select one...
Male
Female
Has received tutoring from any other vendor through CMS?
Yes
No
Email
Phone Number
Childs Grade
Does your child have an Individualized Education Plan (IEP)?
Select one...
Yes
No
Please tell us what your child needs tutoring help with
Requested Tutoring (Check all that apply)
Reading - Phonics & Decoding
Reading Comprehension
Written Expression
Vocabulary
Dyslexia or Dysgraphia
SAT/ACT Prep or Senior Project
ADD & ADHD
Homeschooling or Homework Assistance
Math
I agree to the following:
By filling out this form, I am authorizing I Tutor You to obtain any information from CMS regarding your student school work and testing.
To the best of my knowledge all questions have been answered correctly.
Thank you! Your submission has been received!
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