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	STEP 1 (of 3) - CHOOSE SUBJECTS Our tutors were COMPLETELY booked last semester.  Don't wait to secure a spot for your son or daughter!  You can fill out this form in two minutes.

	High School Subjects
	ACT Prep Advanced Math Topics Algebra 1 (or any variation of 1) Algebra 2 Algebra 2/Trig Alg 2/Trig Honors Biology Biology Honors Biology AP Calc AB Calc BC Chemistry Chemistry Honors Chemistry AP European History European History AP	French 1 - 3 French 4 Honors Geometry Homework Help Math Analysis Physics Physics AP Pre-Calculus Pre-Calculus/Trig Pre-Calculus/Trig Honors Reading Comprehension SAT Prep SAT II: Biology SAT II: Math 2C SAT II: Chemistry SAT II: Literature	SAT II: World History SAT II: U.S. History SAT II: Physics SAT II: Spanish SAT II: French Spanish 1 Spanish 2 Spanish 3 Spanish 4 Honors AP Spanish 5 Statistics AP Strategic Reading (Comprehension) U.S. History U.S. History AP World History Writing
	Other	Enter the name of the subject and any other information that you would like to pass along. You can write beyond the space.

	Elementary & Middle School Subjects
	Algebra Elementary Math Geometry History Homework Help Math 6, 7 or 8	Middle School Math (if you're not sure of the level) Pre-Algebra Science Strategic Reading (Comprehension) Study Skills Writing

	STEP 2 - CHOOSE YOUR PREFERRED LOCATION(S) & DAYS
	Danville Lafayette Moraga
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	STEP 3 - ENTER YOUR CONTACT INFORMATION
	First Name*
	Last Name*
	Your Child's First Name You can include all of your children on one form.
	Home Phone (Enter this number if you would like us to call your home phone. Enter both numbers if you don't care.)
	Cell Phone (Enter this number if you would like us to call your cell phone. Enter both numbers if you don't care.)
	Best Time To Reach You* Morning Afternoon Evening Other: Other Value If you want to enter a more specific time (e.g. 3 - 6 p.m.), click other and enter the times.
	School
	Parent(s) Name(s)
	Email Address*
	Current Grade Level (s) 2 3 4 5 6 7 8 9 10 11 12 Other: Other Value You can enter all of your children on one form.
	Why Are You Contacting Us Today? Bad Grade In The Class Bad Grade On A Test Email from Lafayette Academy My Child Said That He/She Needs A Tutor Postcards Progress Report Referral From Adult Friend Referral From Children's Friend Referral From Counselor Regular Customers Other: Other Value (please check all that apply)
	Can you please list the name(s) of the person(s) who recommended us?
	If you remember the Craigslist or Google Ad headline, please enter it here.
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