Parents' Names:

Child's Name:

Home Address/City/State/Zip:

Home Phone:


Cell Phone:

Work Phone (Mother):

Work Phone (Father):

E-mail Address:

How did you find out about The Hill Tutoring Connection?:

Information About the Child

Age:

Date of Birth:

School:

Grade:

School Contact:

Does your child attend a public or private school?:
Select One Public Private Home School

What county is your child's school in?


Tutoring is needed in what area(s)?:

What are your expectations for tutoring?:

Has your child ever had any diagnostic testing (psychological, educational):
Select One Yes No In Progress

If so, will this information be available to the tutor?:
Select One Yes No

Has your child been identified as needing special services in the school?
Select One Yes No

If so, what was the identification (label) and what services is he/she receiving?


Describe tutor personality traits that would suit your child:


Other relevant information:


Check other services that you have used through The Hill Center:
Half-Day Program - Year:

Enrichment Class - Class Title:

Summer School - Year:

Liasion Program at DA Yes No

Tutoring Information

Kind of Tutor Requested (see descriptions below):
Select One Hill Faculty Tutor Remediation Tutor Content Specialist Generalist Tutor


Tutor Descriptions and Rates

Hill Faculty Tutor
Rate: $68/hour

• Current member of The Hill Center academic year faculty.

Remediation Tutor
Rate: $55/hour

• Bachelor’s or Master’s degree or state certification in learning disabilities/related field.
• Trained in The Hill Center Methodology based on the Orton-Gillingham technique and/or Wilson Methods or LANGUAGE methods.
• Provides remediation for students not reaching his/her potential in the areas of reading, written language, or math.

Generalist Tutor
Rate: $48/hour

• Has a Bachelor’s degree or teaching certification.
• Coaches students in homework completion and academic work.
• Teaches Study Skills and Organization.
• Prepares students for the SAT, ACT, ISEE, EOG, EOC, GED, and the MCAT.

Content Specialist Tutor
Rate: $48/hour

• Has a Bachelor’s degree or teaching certification in a special content area.Teaches high school and/or college courses in math, science, and foreign language.
  

Number of hours per week you are requesting tutoring?