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Student Name*
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Age*
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Parent Name*
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Phone Number*
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EMail Address*
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Home Address*
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City/State/ZIP*
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Were you referred by another family?
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Yes
No
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Family Name:*
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Grade Level*
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Choose Your Times: (Please choose ALL times you would consider *please note that Monday/Wednesday times will not begin after 6pm)
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3:45-4:45
4:00-5:00
4:15-5:15
4:30-5:30
4:45-5:45
5:00-6:00
5:15-6:15
5:30-6:30
5:45-6:45
6:00-7:00
6:15-7:15
6:30-7:30
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Choose Your Dates: (Choose ALL that you would consider)
**Please note that tutoring meets twice a week
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Monday/Wednesdays
Jan. 30
Feb. 1, 6, 8, 13, 15, 20, 22
Mar. 12, 14, 19, 21, 26, 28
Apr. 9, 11, 16, 18
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Tuesdays/Thursdays
Jan. 31
Feb. 2, 7, 9, 14, 16, 21
Mar. 8, 13, 15, 20, 22, 27, 29
Apr. 10, 12, 17, 19
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Please note any conflicts that the student may have (including the day and time):
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How did you hear about Care 2 Learn?
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All groups will meet at the New Hope Baptist Church, 8918 Aboite Center Road.
A deposit of $32 per student is due when registering. The deposit will be
applied towards your student's tuition. Availability is based on a
minimum enrollment of 3 students with a maximum enrollment of 4 per group.
Should your student's class not meet minimum enrollment requirements, all
prepaid fees will be refunded. A $36 discount is available if you register for
both Math and Language Arts.
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*Total cost for entire 9 week program is $288
plus a reasonable consumable fee based on
enrollment, not to exceed $20
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Payment Options
After receiving your registration, Care 2 Learn will send a PayPal invoice to your email address. Your payment of the $32 deposit reserves your student’s space in the class. The deposit can be paid via sending in a check within two days of registration to the PO Box listed below, or via PayPal.
Payments may be made in one lump sum the first day via cash or check. Families also have the option to pay in four equal installments beginning in January 2012 via check or PayPal (3.5% surcharge per PayPal transaction).
All families who register are agreeing to pay for the full 9 weeks of instruction regardless of a student’s attendance.
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