This form will help us learn more about your qualifications and experience. Please complete all sections to the best of your ability.

Personal Information:

  • First Name:
  • Last Name:
  • Email Address:
  • Phone Number:
  • Address:Address:  Unit #  Zip:
  • Date of Birth:*
  • Emergency Contact Name:


  • Highest Qualification Attained:
  • Previous Tutoring Experience (if any):
  • References (if available):


  • Days and Times Available for Tutoring Sessions:
  • Preferred Mode of Tutoring (In-person, Online, or Both):

Rules and Guidelines:

  1. Confidentiality: Tutors are required to maintain the confidentiality of all student information shared during tutoring sessions.
  2. Professionalism: Tutors must maintain a professional demeanor and adhere to the code of conduct outlined by [Your Company Name].
  3. Timeliness: Tutors are expected to arrive punctually for scheduled tutoring sessions.
  4. Preparation: Tutors are responsible for adequately preparing for each tutoring session and providing appropriate materials/resources.
  5. Communication: Tutors should maintain open communication with both students and [Your Company Name] regarding any scheduling conflicts, concerns, or feedback.
  6. Attendance: Tutors are required to inform [Your Company Name] in advance of any planned absences or schedule changes.

Liability Waiver: I, [Tutor's Name], understand and acknowledge that tutoring involves certain risks, including but not limited to physical injury or property damage. I agree to release, indemnify, and hold harmless [Your Company Name] from any and all liability, claims, demands, damages, or expenses arising from my participation as a tutor.

Payment Authorization:

By signing below, I authorize [Your Company Name] to charge the provided credit card for tutoring services rendered at the agreed-upon rates.

Referral Program:

  • I agree to participate in [Your Company Name]'s referral program and abide by the terms and conditions outlined by the program.