Student's Name *

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Tutoring Location *

Where would you like our tutor to meet you? (At home, library, coffee shop, etc.)

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Parent 1 *

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Parent 1 Phone Number *

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Parent 2

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Medical/ Personal Information *

Please check all that apply so that we can better assist your child. *Please note, Old School may not be able to accommodate certain needs. If you have questions about whether we are equipped to work with your child, please contact us at 713-510-3164.

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Aspergers

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Section 504 Accommodations

Special Education*

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Professional Liability Disclaimer *

Old School Tutoring is committed to providing a professional and high quality service that is affordable for parents and effective for students. By reading this disclaimer you understand the rate at which people learn and acquire information varies. As a result, we can only state the possible and probable improvement that you or your student may make and experience as a result of using the private tutoring services of Old School Tutoring. By acknowledging this disclaimer, you agree not to hold Old School Tutoring or any of its educational consultants legally liable if you do not achieve the academic improvement or performance that you are anticipating by using our tutoring service.

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