Full Name (required) Your Email (required) Your Cell Phone(required) Student Name(required) Student grade level FALL 2023 (required) NEW STUDENT Tutoring Needs CURRENT SCHOOL YEAR 2022-2023 LAST DAY OF SCHOOL YEAR TUTORING(required) Summer 2023 Tutoring I am interested in summer tutoring. YESNO SUMMER TUTORING NEEDS FIRST DAY OF SUMMER TUTORING (REQUIRED) Preferred day(s) and time: 2023-2024 School Year Tutoring My student(s) will continue tutoring 2023-2024 year: YESNO Fall Start Date:(REQUIRED) Tutoring: 1 Hour Sessions1.5 Hour SessionsOther If Other: How many sessions per week?: PREFERED DAY(S) AND TIME Monday: Tuesday: Wednesday: Thursday: Friday: Homeschool Program Please contact me regarding UPHH's year-round homeschool program. YES, PleaseNO, Thank you *Note: Required for all students Annual Supply Fee - $50 (added to first invoice) New Students only - How did you hear about us?: If a friend referred you, who was it?: