Life Time Tutoring Ministry: individualized instruction for over 27 years

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Life Time Tutoring Information Sheet
  1. Please fill in all fields and click submit.


  2. Full Name Parent/Guardian(*)
    Please type your full name.
  3. E-mail(*)
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  4. Students Name
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  5. Address
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  6. City
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  7. State
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  8. Zip
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  9. Phone
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  10. Cell
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  11. Earliest and Latest time to be called
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  12. Place of Employment
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  13. Job Position or Title
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  14. Work Phone
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  15. Work Hours/Days
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  16. Name of Spouse
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  17. Spouse Cell
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  18. Spouse Place of Employment
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  19. Spouse Job Position or Title
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  20. Spouse Work Phone
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  21. Spouse Work Hours/Days
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  22. Contact Phone Numbers

  23. Contact Name
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  24. Contact Phone
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  25. Relationship to Parent or Guardian
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  26. Contact Name
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  27. Contact Phone
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  28. Relationship to Parent or Guardian
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  29. Contact Name
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  30. Contact Phone
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  31. Relationship to Parent or Guardian
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  32. Full Name of Student
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  33. Age
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  34. Birthday
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  35. Nickname
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  36. Grade
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  37. School
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  38. School Phone
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  39. Check Subject Area(s) Which Need Improvement
  40. READING
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  41. MATH
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  42. SCIENCE
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  43. SOCIAL STUDIES
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  44. SPELLING
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  45. ENGLISH
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  46. LANGUAGE
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  47. BEHAVIOR
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  48. WORK HABITS
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  49. HANDWRITING
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  50. STUDY SKILLS
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  51. Please check the days that student is not available.
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  52. Long-Term Goals and Schedule

  53. Goals
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  54. What specific ideas and/or methods would assist your child's tutor to reach these goals? Please write anything about your child that would help us in tutoring them. Please list your child's hobbies and personality type.
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  55. Please list all your child's siblings and their ages:
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  56. School History

  57. Please include the school name location and approximate grades received on report cards. Also, share any helpful information about your child during the past school years. Please include important information about the teacher or child's situation during the year.
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  58. Anticipated Length of Time for Tutoring

  59. Weeks
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  60. Months
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  61. Years
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  62. Spam Control(*)
    Spam Control
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