New Student Form (BLUEPRINT)
Welcome to Ivy Tutors. We're excited to be on your team!
This form can be a little tricky, so here are some instructions.
Please fill in the
guardian's info
at the top of the form (email and tel #) and the
student's info
in the bottom half of the form (the student's info is optional and can be left blank if you don't want them to receive lesson notes, reminders, etc).
We must have a credit card to keep on file, but if you put in your bank account details below and choose ACH as your preferred payment type, we will not charge your credit card. After your account is activated, you can fill in your ACH details. If you fill in your bank details, you are agreeing to be charged via ACH payments. Your first lesson will be charged up front. If you pay-as-you-go for 1:1 sessions, you will be charged on Monday for tutoring services rendered in the past week. After each session, our tutors go in and confirm that the session took place and add the time details. That's how we know what to charge you. If you are on a package deal or in a semi-private, you will not have the weekly charges.
The first session is charged when booked. After that, lessons are charged for every Monday for the previous week's sessions. Credit card payments incur a 4% fee.
Once you're done with this form, we'd love the student to fill out this quick survey about his/her/their learning mindset:
https://forms.gle/Cd6KUkZTsvrENqCw8
Thank you!
First Name
Last Name
Preferred Pronouns
Email
Mobile Phone
Address
Address Line 2
City
State
Zip
Country
Select country...
United States
Canada
United Kingdom
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Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia, Plurinational State of
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, the Democratic Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, the former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela, Bolivarian Republic of
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Payment Type
Select
Card 4%
Package
ACH
School
Credit Card Details
By submitting your credit card, you consent to have your credit card charged on your behalf for tutoring services rendered.
Confirm Email
About the Student
First Name
Last Name
Preferred Pronouns
Email
Mobile Phone
Birth Date
School
High School Graduation Year
Subjects
ACT
ADD/ADHD
Algebra
Algebra 2
Anthroplogy
AP Art and Design: 2-D Design
AP Art and Design: 3-D Design
AP Art and Design: Drawing
AP Art History
AP Biology
AP Calculus AB
AP Calculus BC
AP Chemistry
AP Chinese Language and Culture
AP Computer Science A
AP Computer Science Principles
AP English Language & Composition
AP English Literature & Composition
AP Environmental Science
AP European History
AP French Language & Culture
AP German Language & Culture
AP Government and Politics (Comparative)
AP Government and Politics (US)
AP Human Geography
AP Italian Language & Culture
AP Japanese Language & Culture
AP Latin
AP Macroeconomics
AP Microeconomics
AP Music Theory
AP Physics
AP Psychology
AP Research
AP Seminar
AP Spanish Language & Culture
AP Spanish Literature & Culture
AP Statistics
AP Studio Art
AP US History
AP World History: Modern
Arabic
Audition Prep
Biology
Calculus
Chemistry
College Admissions Coaching
College Essay
Computer Science
Danish
Debate
Early Childhood Education
Earth Science
Economics
Elementary Math
English
English for Multilingual Learners
English Literature
Environmental Science
European History
Executive Functioning
French
Geography
Geology
Geometry
Global Studies
GMAT
Government and Politics
GRE
Greek
Homeschooling
Homework Help
HSPT
Hunter HS Entrance Exam
IB Curriculum Essay
ISEE Lower/Middle
ISEE Upper
Italian
Kindergarten
Latin
Learning Pods
Linear Algebra
Living Science Regents
Logic
LSAT
Mandarin
MCAT
Music
Music Theory
Neuroscience
OG or LMB for Dyslexia
OLSAT
Organization Help
Other Learning Disorders
Physical Science (Elementary)
Physics
Physics with Calculus
Pre Calculus
Psychology
Reading Skills
Remote School Support
Research Mentorship
Russian
SAT
Science Writing
Sciology
SHSAT
Social Studies
Spanish
Special Education
SSAT Elementary/Middle
SSAT Upper
State Exams (Common Core)
TACHS
Test Anxiety
Trigonometry
US History & Government
Voice
World History
Writing Skills
Accommodations (select all that apply)
Time and a half
Double Time
Dyslexia
Dysgraphia
Dyscalculia
Executive Functioning
Aspergers
Autism
Language Processing Disorder
Auditory Processing Disorder
Visual Perceptual/Visual Motor Deficit
ADHD
Nonverbal
Memory
Student's grades? Best and worst subjects? GPA?
Primary goal of tutoring? (Please be specific -- e.g. a test score or grade goal?)
Why is this goal important? Part of a bigger goal? (specify school applying to, if applicable)
What is/are the biggest obstacle(s) to achieving the goal?
Gets anxious about school or before/during a test?
Select
Always
Sometimes
Rarely
Never
Runs out of time on tests?
Select
Always
Often
Sometimes
Never
Two things the student is really good at:
One or two things the student wishes he/she could be better at:
Any potential or diagnosed learning differences? Anything else we should know?
Were you referred by someone we can thank?
Remove
Add Fields for Additional Student
Submit