Creative Connections Educational Consulting Group, LLC
Changing the Face of Education Today!
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Tutoring Application
Please complete the application to register your child for a Free Assessment before tutoring is scheduled.
*Name (last, first, middle initial)
*Address (street, city, state, zip)
*Phone number
*Email Address
*Child's Name (last, first, middle)
*age
*child's dob
*Child's grade
*Name of School
*Child's grade
*Does your child have a learning disability?
Yes
No
*Has your child ever been tested?
Yes
No
*If so, what type of test was used and what were the results?
*What subject(s) does your child need help in?