Virtual Tutoring Services with Sharhonda Jeffries
Registration information
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
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New Hampshire
New Jersey
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New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone Number
*
E-mail
*
example@example.com
How did you hear about Sharhonda Jeffries' services?
*
Please Select
Referred from a friend
Facebook
Instagram
Other
Student's Name
*
First Name
Last Name
Grade level
*
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Choose the 3 areas of MATH that you would like for us to work on.
Counting
Identifying numbers
Addition
Subtraction
Multiplication
Division
Math fluency
Choose the 3 areas of READING that you would like for us to work on.
Writing letters
Writing about reading
Identifying letters/sounds
Vocabulary
Reading comprehension
Reading fluency
What is the student's favorite color and thing to do?
*
What are 2-3 goals I can help your student accomplish this year?
*
Do you AGREE to have the registration fee of $20 and the first week's session fees paid before services begin.
*
Yes
No
Which weekly plan is your family interested in? Each session includes a 5-minute "warm-up", a 35-minute 1-on-1 tutoring lesson, and a 5-minute "cool down" period.
*
1 session/wk = $60
2 sessions/wk = $120
3 sessions/wk = $160
Please share a photo of the child that you are enrolling for our digital welcome packet!
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Please type YES if you GIVE PERMISSION to have photographs and/or recordings of your child shared on our social media pages. Type no, if you decline.
*
Have friends/family who have mentioned needing to get their child(ren) a tutor? REFER THEM to us for a $30 credit towards your child's next session after they register. Please give a reference of any two parents whom you feel could use my services:
Parent's Name
Contact Number
Child's Current Grade Level
1
2
Registration Payment
*
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Tutoring Registration Fee
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
Please type "I ACKNOWLEDGE & AGREE" to acknowledge and agree that you are aware and agree to pay a rescheduling fee of $60 for cancellations less than 24 hours in advance. You are also acknowledging that all tutoring sales are final. Type no, if you decline.
*
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Ready to grow together!
Ready to grow together!
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