Student Registration Form STUDENT REGISTRATION FORM Student Name* First Last Gender*FemaleMaleNon-Binary/OtherPreferred PronounsStudent Email* Student Cell Phone NumberSchoolGraduating Year201920202021202220232024 PARENT/GUARDIAN INFORMATIONPrimary Parent* First Last Cell Phone Number*Home Phone NumberEmail* Would you like to add contact information for another parent/guardian?*NoYesSecondary Parent First Last Cell Phone NumberHome Phone NumberEmail What kind of tutoring service are you seeking?*Test PreparationAcademic CoachingWriting CoachingSubject TutoringProctored Practice TestWhat type of writing are you interested in improving?* Academic (e.g., term papers or lab reports) College Application Essays (Common App or supplemental) Creative (fiction or nonfiction; e.g., short stories, etc.) Resumes or Cover Letters Other Which test(s) are you preparing for?*SATACTUndecided between SAT and ACTSAT Subject TestsSSATISEE/HSPTGRELSATGMATMCATWhich subject(s)?* Literature US History World History Mathematics (Level 1 or 2) Biology E/M Chemistry Physics Foreign Language Which language(s)?*Upper Level or Middle Level?*Upper Level (entering grades 9-11)Middle Level (entering grades 6-8)Test Date (if applicable) Date Format: MM slash DD slash YYYY PSATTotalReading + WritingMathSATTotalReading + WritingMathEssayPreACTCompositeEnglishMathReadingScienceACTCompositeEnglishMathReadingScienceWritingIf relevant, colleges/grad programs applying to:Please select the desired subjects for tutoring:* Math English History Science Reading Foreign Language Other Foreign Language:Writing Sample Drop files here or Accepted file types: pdf, docx, txt, pages. If you'd like to, please attach a writing sample of recent work. Writing samples are used only for assessment, not review or editing.Do you have any educational concerns you'd like to share with us? Please explain. SCHEDULING/AVAILABILITY All scheduling is done pending tutor availability, but whenever possible we make a recommendation for tutor pairing that fits your scheduling needs. To allow us to do so, please complete the below fields regarding your student's availability. Please check the time ranges below that do NOT work for you: Monday 2-5pm Monday 5-8pm Tuesday 2-5pm Tuesday 5-8pm Wednesday 2-5pm Wednesday 5-8pm Thursday 2-5pm Thursday 5-8pm Friday 2-5pm Saturday 10am-1pm Saturday 1-4pm Sunday 11am-1pm Sunday 1-4pm Would you prefer to meet at North Avenue's West or East side office?Our East side office is currently open Saturdays, Sundays, Mondays, and Tuesdays. West side: 1235 SW 16th Ave. East side: 975 SE Sandy Blvd. Last but not least, how did you hear about North Avenue Education?*Friend or ClassmateTeacher or College CounselorGoogle SearchYelp SearchFacebookWalked ByWho referred you to North Avenue? We'd love to thank them!* This iframe contains the logic required to handle Ajax powered Gravity Forms.