Enrollment Form for the School Year

We wish to enroll the following student at the days and times checked below. (Please complete a new form for each individual student): *

Please check the Master Schedule to determine available spaces:

Mondays:

3:00 - 3:55
4:00 - 4:55
5:00 - 5:55
6:00 - 6:55

Tuesdays:

3:00 - 3:55
4:00 - 4:55
5:00 - 5:55
6:00 - 6:55

Wednesdays:

3:00 - 3:55
4:00 - 4:55
5:00 - 5:55
6:00 - 6:55

Thursdays:

3:00 - 3:55
4:00 - 4:55
5:00 - 5:55
6:00 - 6:55

Fridays:

3:00 - 3:55
4:00 - 4:55
5:00 - 5:55
6:00 - 6:55

Saturdays:

10:00 - 10:55 a.m.
11:00 - 11:55 a.m.
12:00 - 12:55 p.m.

Please indicate your start date (we will hold a space for a maximum of two weeks): *

Please indicate your preferred method of payment (tuition fees are due monthly, on the first session of each month):

I/we would like to pay by Interac Email Funds Transfer sent to mail@the-math-tutor.ca
I/we will pay the Tuition Fees by Cheque mailed on or by the first day of class of each month, payable to The Math Tutor, 72 Rutledge Road, Mississauga, ON L5M 1H4

Student's date of birth:

Name of school he/she is presently attending: *

Current Grade Level in School: *

Special health or behavioural concerns, or any other matter you feel we should be aware of (please specify):

Name of parent(s) or Legal Guardian(s): *

Address: *

City, Province, Postal Code: *

Email *

Home Telephone:

Cell Phone:

By submitting this form, I/we agree to commit to have our son or daughter attend the online tutoring sessions on the dates and times specified above, and to pay the tuition fees as outlined on the Tuition Fees page of this website, and in accordance with the policies outlined in the "Policies & Procedures" page of this website. *

I agree with the above statement

We will be in touch with you shortly to confirm the days and times chosen for this enrollment.