Enrollment Form

Enrollment Form

Due to the high demand, at the present time we are only able to offer spaces to families who have been previously enrolled with us.

Please note that you will receive a “Confirmation of Enrollment” from us before the student can be officially enrolled. Also, for new families joining us, we require an in-person interview before the enrollment can be confirmed.

In addition to the Enrollment Form (below), please also submit the “Policies & Procedures” form when enrolling your son or daughter.

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:

• 2:00 - 2:55
• 3:00 - 3:55
• 4:00 - 4:55
• 5:00 - 5:55
• 6:00 - 6:55

Tuesdays:

• 2:00 - 2:55
• 3:00 - 3:55
• 4:00 - 4:55
• 5:00 - 5:55
• 6:00 - 6:55

Wednesdays:

• 2:00 - 2:55
• 3:00 - 3:55
• 4:00 - 4:55
• 5:00 - 5:55
• 6:00 - 6:55

Thursdays:

• 2:00 - 2:55
• 3:00 - 3:55
• 4:00 - 4:55
• 5:00 - 5:55
• 6:00 - 6:55

Fridays:

• 2:00 - 2:55
• 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 choose whether you wish to have "online" or "in-person" tutoring. Note: "in-person" tutoring will take place in our classroom at 2630 Inlake Court, Mississauga. *

• Online Tutoring
• In-person Tutoring

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

• I/we would like to have the Tuition Fees transferred directly from my/our Bank Account by means of Electronic Funds Transfer (EFT). (Please provide us with a voided cheque)
• I/we would like to pay by Email Money Transfer (EMT) sent to mail@the-math-tutor.ca
• I/we will pay the Tuition Fees by Cheque or Cash, on or by the first day of class of each month

Student's date of birth:

Name of school he/she is presently attending: *

Current Grade Level in School: *

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

For students in grades 1 - 8: I/we authorize the following adults to have permission to pick up my child at the end of the class:

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 not hold "The Math Tutor" or any of its staff or representatives, or the Meadowvale Community Church, or any of its staff or representatives liable or in any way responsible for any accident, mishap or other occurrence on the way to or from class, or during the class time. I/we hereby authorize the staff of "The Math Tutor" to take whatever action they deem in the best interest of the student in any emergency requiring medical attention. *

• I agree with the above statement

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

Name

Submit