Clients

New Student Registration

Private Tutor Atlanta- Simplifying Learning

Student Name:

Parent/Caretaker (if student is under 18):

Student's Classroom Teacher (if applicable) :

Company/Organization Requesting Service (if applicable):

Student Address:

Student Email:

Student Phone Number:

Student's Date of Birth:

Student's Grade/Highest Level of Education:

Job/Career/Field of Study:

Target Goal(s):

Concerns Related To The Goal(s) :

ESL Students- Who Speaks the Most English To You?

PAYMENT/CANCELLATION POLICY: Please Check Each Statement Below To Mark You Have Read Our Policy

Sessions are Pre-Paid at Time of Reservation. We Accept Cash or Credit Card Payments

Weekly Reservations Require a Security Deposit Equivalent to the Cost of Your Weekly Session

We Have a No-Refund Policy for Weekly Reservations; Sessions May Be Rescheduled with the Week Pending Availability

Security Deposit Reserves Your Weekly Spot , Will Cover Missed Payment, and Can Be Applied to Your Last 2 Sessions (Pending No Missing Payments)

Tutoring Location:

How did you hear about us?

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"May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope." (Romans 15:13)

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"The thief comes only to steal and kill and destroy. I came that they may have life and have it abundantly." -Jesus (John 10:10)

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"Whatever you do, work heartily, as for the Lord and not for men," (Colossians 3:23)

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"For the wages of sin is death, but the free gift of God is eternal life in Christ Jesus our Lord." (Romans 6:23)

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" And this is eternal life, that they know you, the only true God, and Jesus Christ whom you have sent." (John 17:3)

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" For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life. For God did not send his Son into the world to condemn the world, but to save the world through him." (John 3:16-17)

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