2025-2026 Forms 2025-2026 Policies 2025-2026 Policies Name of person filling out this form * First Name Last Name Your Email Address * STUDENT INFORMATION Name If different from above First Name Last Name Grade Level/Year * School * POLICIES STUDENT PHONE POLICY * To foster an environment most conducive to learning, I ask that student cell phones remain on silent and be kept away. BY TYPING YOUR NAME BELOW, YOU/YOUR CHILD AGREES TO THIS POLICY. PAYMENT AGREEMENT * *UPDATED* 2025-2026 RATES 30 min Zoom check-in: $75 55 min Session: $135* *Communication with parents/teachers/outside providers beyond 15 minutes a week and attendance at meetings: $40 each 15 mins Payment will be requested via Venmo and must be completed within 24 hours of receipt. BY TYPING YOUR NAME BELOW, YOU AGREE TO THESE TERMS. STUDENT CANCELLATION AGREEMENT * Same-day cancellations not due to illness/emergency and no-shows (if a student has not arrived/signed in after 15 minutes of the appointment time) will be billed in full. BY TYPING YOUR NAME BELOW, YOU AGREE TO THESE TERMS. INSTRUCTOR CANCELLATION AGREEMENT * Sessions will not be held on days off of school or during student breaks (unless agreed upon). I will let you know well in advance of any sessions I need to cancel due to conflicts. In the case of a last minute cancellation due to illness or a family-related issue, I will notify you as soon as possible. Every effort will be made to schedule a make-up session in-person or via Zoom. BY TYPING YOUR NAME BELOW, YOU AGREE TO THESE TERMS. Thank you! New Student Information New Student Information STUDENT INFORMATION Name * First Name Last Name Grade Level/Year * School * Phone Number (if applicable) (###) ### #### Email Address (if applicable) PRIMARY PARENT CONTACT Name * First Name Last Name Phone Number * (###) ### #### Email Address * SECONDARY PARENT CONTACT Please complete if I will be communicating with both parents. Name First Name Last Name Phone Number (###) ### #### Email Address FINANCIAL RESPONSIBILITY Who is responsible for submitting payments? * Venmo Name * Thank you! Please complete the “2024-2025 Policies” form. Helpful Links Recommended Academic Planner Click here to purchase the "Order Out Of Chaos" planner. EF Overview Click here for a quick overview of EF, from understood.org.