Consultation Registration - English, Math & More

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Choose the consultation service that best reflects what you think you need. *

Consultation for Tutoring or Test Preparation
Consultation for English Language Learning

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Are you applying for yourself, or are you applying for someone else? *

If you're completing this application for someone else, such as a child, student, employee, or friend, enter that person's name and your relationship to the person. Also, complete the remaining fields as if you are the person for whom the application is being completed. If you're completing the application yourself, enter "self".

Individual or Group Application? *

Individual
Group

Groups of two or more receive a 10% discount per person, and group members must operate at the same level.
If applying as a group, please list all group members' names.
If applying as a group, each group member needs to submit a separate application.

You are applying for: *

Tutoring Consultation
Test Preparation Consultation

Your Name *

Email *

Phone (XXX-XXX-XXX)

Be sure to include the area code. Include a country code if located outside the United States of America.

Zip Code *

Country *

Are you a student? *

For test preparation customers: name the test(s) for which you need preparation. *

For tutoring customers: name the subject(s) with which you need learning assistance. *

Is English your primary language? If not, please list your primary language and any other languages in which you communicate. *

Do you have a specific goal? *

The answer seems obvious, but it is usually different for everyone. Please, be sure to answer this question.

On what day do you need to receive your consulting report? *

If you don't know EXACTLY when you need it, it is okay to guess. If possible, though, list a specific date.

Do you have--or have you ever had--an IEP (Individiual Education Plan)? If so, what are/were the issues with which you struggle(d)? *

Do you have any health concerns or limitations (i.e., allergies, asthma, etc.)? *

Having this information ensures that I don't plan activities that are too physically discomforting.

Is there anything else you think I should know about you or your specific situation? *

How did find English, Math & More? *

Bing
Google
Yahoo
I clicked an ad.
Facebook
Family Member
Friend
Counselor
Flyer
Other

I know this question is annoying, but answering helps me determine how to improve my marketing efforts. Teaching's my strength. Marketing is not.

Registration Fee(s) *

Application Processing - $49.00

Check this box to begin payment process.
This fee needs to be submitted before the processing of your application and scheduling of your diagnostic session.

The application fee:
1. Covers time spent evaluating your application and arranging your diagnostic session.
2. Signals your seriousness.
3. Will be credited to your account after your tenth (10th) session.
4. Is non-refundable.

CREDIT: The application fee will be credited to your account after you complete your tenth (10th) session. Think of it as earning a free session.

DROPPING THE BALL: This registration is valid only for 30 days. If you submit an application and registration fee but fail to move forward with the rest of the process, beginning Day 31, you will need to reapply and resubmit an additional registration fee. Your original registration fee will not be refunded.

NEXT STEPS: After your application and registration fee are received, almost immediately, you will receive a generic confirmation and receipt. Within two (2) business days, you will receive a personalized email that contains instructions for scheduling your diagnostic session. OPEN AND RESPOND TO THE EMAIL AS SOON AS POSSIBLE. If you do not schedule and complete your diagnostic session within 30 days, you will forfeit your current application and processing fee. You will need to re-apply (i.e., complete another application and processing fee).

Contact Kenisha (kcarr@englishmathmore.com; 510-495-0687; 888-867-1441;) with any concerns. For legal purposes and convenience, emailing is preferred, but calls are still welcomed. Thanks.

Checkout: Please, enter information only once. *

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Please enable JavaScript in your browser to complete this form.

Individual or Group Application? *

Individual
Group

Are you applying for yourself, or are you applying for someone else? *

If you are completing this application on behalf someone else, such as a child, student, employee, or friend, enter the name of that person and your relationship to the person. Also, complete the remaining fields as if you are the person for whom the application is being completed. If you are completing the application for yourself, enter "self".

Your Name *

Email *

Phone (XXX-XXX-XXX)

Be sure to include the area code. Include a country code if located outside the United States of America.

Zip Code *

Country *

Are you a student? *

What is your primary language? *

Do you have a specific goal? *

The answer seems obvious, but it is usually different for everyone. Please, be sure to answer this question.

When do you plan to begin lessons? *

If you do not know EXACTLY when you will be able to start, it is okay to guess. If possible, list a specific date.

Do you have--or have you ever had--an IEP (Individiual Education Plan)? If so, what are/were the issues with which you struggle? *

Do you have any health concerns or limitations (i.e., allergies, asthma, etc.)? *

Having this information ensures that I do not plan activities that are too physically discomforting.

Is there anything else you think I should know about you or your specific situation? *

How did find English, Math & More? *

Bing
Google
Yahoo
I clicked an ad.
Facebook
Family Member
Friend
Counselor
Flyer
Other

I know this question is annoying, but answering helps me determine how to improve my marketing efforts. Teaching is my strength. Marketing is not.

Registration Fee(s) *

Application Processing - $49.00

Checkout: Please, enter information only once. *

SSL protected via Stripe.