NATIONAL TERRITORY PREMIER LESSON REPORT FORMS 2012
Student & tutor info
Student name (first and last)
Tutor name (first and last)
Tutor Phone Number
Tutor Email Address
Market
Please Select
Akron
Albany
Albuquerque
Ann Arbor
Binghamton
Birmingham
Boulder
Buffalo
Burlington
Chapel Hill
Charlotte
Cincinnati
Cleveland
Columbia, SC
Columbus
Dayton
Denver
Detroit
Durham
East Lansing
Greenville
Honolulu
Huntsville
Ithaca
Kansas City
Knoxville
Lawrence
Lexington
Louisville
Memphis
Nashville
New Orleans
Phoenix
Pittsburgh
Provo
Rochester
Salt Lake City
St Louis
Syracuse
Tucson
Westchester/Connecticut
Test
Please Select
SAT
ACT
PSAT
SAT Subject Test
AP
ISEE
SSAT
Subject (e.g. ACT Math, SAT Critical Reading)
Expected test month and year (e.g. May 2012)
Please Select
Feb 11, 2012 - ACT
Mar 10, 2012 - SAT
March MME - Michigan Students Only
April 14, 2012 - ACT
May 5, 2012 - SAT
June 2, 2012 - SAT
June 9, 2012 - ACT
September 8, 2012 - ACT
October 6, 2012 - SAT
October 17 or 20, 2012 - PSAT
October 27, 2012 - ACT
November 3, 2012 - SAT
December 1, 2012 - SAT
December 8, 2012 - ACT
January 26, 2013 - SAT
February 9, 2013 - ACT
March 9, 2013 - SAT
April 13, 2013 - ACT
May 4, 2013 - SAT
June 1, 2013- SAT
June 8, 2013 - ACT
How far do you travel each way to the tutoring location?
Please Select
Base Rate: between 1-19.9 miles (one way)
TIER1001: between 20 - 49.9 miles (one way)+$5/hr
TIER 1002: between 50 - 74.9 miles (one way) +$12/hr
TIER 1003: between 75 - 99.9miles (one way) +$20/hr
TIER 1004: over 100 miles (one way) +$25/hr
This lesson
Date of lesson
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Month
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Day
Year
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Length of lesson in hours (should always be 2 hours unless otherwise decided by you, the family, and the office)
Total hours you've completed with this student including this lesson (e.g. 2 or 26)
Total hours in tutoring package
Please Select
6 hours (3 lessons)
8 hours (4 lessons - AP/SAT Subject only)
12 hours (6 lessons)
15 hours (10 lessons - ISEE/SSAT only)
20 hours (10 lessons)
26 hours (13 lessons)
32 hours (16 lessons)
48 hours (24 lessons)
Content and homework
Which new topics were covered?
Which old topics were reviewed?
What was student's progress and attitude during lesson?
What percentage of assigned homework was completed?
What homework was assigned for next lesson including proctored practice tests?
When is the next scheduled tutoring session (if arranged yet)?
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Month
-
Day
Year
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Would you recommend more tutoring hours for your student in order to reach their goal? If so how many?
Is there anything else we should know about the lessons you've had with this student (e.g. conversations with parents, online access, wrong book edition, need additional books)?
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