Date: Format: mm/dd/yyyy
Student Name (required) Student Email (required) Additional Student Name Additional Student Email Name of Parents (required) Street Address (required)
City (required)State (required)Zipcode (required)
Home Phone (required)
Mother’s Cell (required)Mother’s Email
Father’s Cell (required)Father’s Email
Emergency Contact (required) Emergency Phone (required)
Relationship (required)
Client grants permission to communicate via phone/text/email in regard to any activity related to Valencia Tutors Learning Center services.
I Agree
Clients understand that all tutoring is done in a small group setting. These are not private sessions.
Client understands that their student may need both first and second semester in order to complete an entire school year's worth of credit.
Course 1(required) Fall Section Section #1 • Aug 26 – Dec 6Section #2 • Sept 3 – Dec 3Section #3 • Sept 25 – Dec 8 Spring Section Section #1 • Jan 22 – May 3Section #2 • Feb 5 – May 17Section #3 • Feb 26 – May 10
Course 2 (optional) Fall Section Section #1 • Aug 26 – Dec 6Section #2 • Sept 3 – Dec 3Section #3 • Sept 30 – Dec 6 Spring Section Section #1 • Jan 22 – May 3Section #2 • Feb 5 – May 17Section #3 • Feb 26 – May 10
*Section choice/time is dependent on availability and will be confirmed through communication with the office.
Courses are not open ended and must be paid in full before a course completion notice is generated and made official. Students who do not complete a course are financially responsible for all course fees. Courses must be paid in full once a student is enrolled. Courses start when the first payment is made. The courses may not be dropped. There are no refunds.
Signature: Date: Format: mm/dd/yyyy
Payment Plans are available. Please contact the office.
Additional Fees - Lost books will need to be replaced at the cost of the student. Make-up sessions incur an additional fee due to missed classes without communication with the office
I hereby authorize Valencia Tutors Learning Center to charge my credit card for payment and/or default in payment.
Course Completion Notices must be signed for by the parent or student.
All services must be paid in full BEFORE Course Completion Notices are released.
Final payment may be paid in cash or by credit card ONLY.
By enrolling my student in Valencia Tutors’ courses, I am agreeing to the terms mentioned above for course completion, payment, and release of completion notices.
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