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Registration
Registration Form En (Except QC)
Discount
Branch
Referral client ID
Referral client email
Source
What service is this registration for?
*
Select...
In-Home Tutoring
Online Tutoring
First name
*
Last name
*
Email
*
Mobile #
*
Phone # (home/job)
*
Address
*
Province
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Ontario
Quebec
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Prince Edward Island
Saskatchewan
Student full name
*
Study level
*
Select...
Elementary
High school
College/University
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*
Select...
Elementary
High school
Cegep/University
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*
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*
Session
*
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Student difficulties and/or other details
Reference
*
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Google , Bing, Yahoo
District School Board
Friends / Family
Newsletter
Facebook
Instagram
Other
School Code
Package
*
Select...
Pay as you go - À la carte
20 hours prepaid package - 1 FREE hour
30 hours prepaid package - 3 FREE hours
40 hours prepaid package - 5 FREE hours
Frequency
*
Select...
1 lesson / week
2 lesson / week
3 lesson / week
If you are human, leave this field blank.
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