Child Inquiry Form2 | WizEducators

Parent's First Name*
Parent's Last Name*
Parent's Email Address*
Parent's Phone Number*
Child's First Name*
Child's Last Name*
Child's Grade*
Subject Area(s) of Concern*
Preferred Location for Tutoring*

House or public space, please be specific
Are you open to meeting at a local library?*
- Yes
- No
Desired Start Date*

ASAP or a specific date
Desired Days/Times for Sessions*
What City Do You Live In?*
Desired Hours Per Week*

How many hours would you like your tutor to come per week?
Desired Range for Payment*

Tutor's hourly rates range from $35-60 per hour depending on experience levels.
Gender Preference for Educator*
Additional Details*
Explain any learning concerns or helpful information for the tutor
Add a Sibling?
- Yes, I also need a tutor for a sibling
Sibling Information
Child's First Name*
Child's Last Name*
Child's Grade*
Subject Area(s) of Concern*
Preferred Location for Tutoring*

House or public space, please be specific
Are you open to meeting at a local library?*
- Yes
- No
Desired Start Date*

ASAP or a specific date
Desired Days/Times for Sessions*
What City Do You Live In?*
Desired Hours Per Week*

How many hours would you like your tutor to come per week?
Desired Range for Payment*

Tutor's hourly rates range from $35-60 per hour depending on experience levels.
Gender Preference for Educator*
Additional Details*
Explain any learning concerns or helpful information for the tutor
Emergency Contact (separate from the parent listed)
Emergency Contact (separate from the parent listed)
Name*
Phone*
Allergy Information
Pediatrician Clinic
Pediatrician Name
Pediatrician Phone Number:
Are there any medical concerns that we should be aware of?
Who will be picking up your child? (Please list all approved adults below)*
Student Interests/Hobbies/Strengths (This helps us get to know them better!)*
Payment
One-Time Finder's Fee
Price:
We will provide you with up to two good-fit tutors for your child within 30 days of initial payment. Once you decide to move forward with an educator, payment for each session will be handled between the parent and tutor. You will receive a full refund if we are unable to present you with at least one good-fit educator within 10 days of initial payment. At that time, we will inform you that we don’t currently have anyone in our network that aligns with your child’s needs. You will receive a 50% refund ($25) if you choose to decline our first educator referral and we are unable to present you a second tutor within 30 days of initial payment.
Add a Sibling (+$25)
- Yes, I also need a tutor for a sibling
WizEducators Scholarship Fund
Support children and families who don't have the resources to hire a tutor or enroll in a extracurricular academic activity.
Total
$0.00
Credit Card
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Consent*
I agree to the privacy policy and terms of use.*
Consent*
I agree to the Behavior Policy.*
Consent*
I agree to the Summer Camp Waiver.*
Agreement:*
By signing this, I have read and agreed on the terms and conditions above.
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Sibling Information

Emergency Contact (separate from the parent listed)

Emergency Contact (separate from the parent listed)

Payment