Consultation Registration Form

Consultations are totally optional, but some parents and students want a phone or in-person consultation before committing to tutoring. A 10-minute phone consultation is free. A 30-minute consultation, either by phone, video chat, or in-person, is $49. Filling out this form can help us, help you make the most of a quick, free consultation, or a more in-depth consultation, to make sure that our tutoring services are the right fit for your student. A household can have up to two 10-minute consultations total (maximum of one per child, per calendar year.)
Student's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Parent's/Guardian's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please be advised that our lowest tuition rate is about $250/month for once-a-week tutoring for one student. 

Which services are you interested in signing up for? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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{binding Name} - {binding Description}{binding displayValue}
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{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}
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Processing PayPal Payment

Consultation Registration Form

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}
Student's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Student is {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Parent's/Guardian's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Parent's Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What are you signing up for today? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What are your goals for tutoring for this student? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What are your top 5 questions for this phone call? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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In the next 3 days, what is your availability for a consultation? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What is your maximum monthly budget for investing in tutoring/coaching with Empowered Learning? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Which services are you interested in signing up for? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Consultation Registration Form

Consultations are totally optional, but some parents and students want a phone or in-person consultation before committing to tutoring. A 10-minute phone consultation is free. A 30-minute consultation, either by phone, video chat, or in-person, is $49. Filling out this form can help us, help you make the most of a quick, free consultation, or a more in-depth consultation, to make sure that our tutoring services are the right fit for your student. A household can have up to two 10-minute consultations total (maximum of one per child, per calendar year.)

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}
Student's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Student is {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Parent's/Guardian's Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Parent/guardian is {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Parent's Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What are you signing up for today? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What are your goals for tutoring for this student? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What are your top 5 questions for this phone call? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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In the next 3 days, what is your availability for a consultation? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What is your maximum monthly budget for investing in tutoring/coaching with Empowered Learning? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Which services are you interested in signing up for? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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