Dawn Learning Center | Application Process

Parent Name 1

Parent Name 2

Address

Street Address

Apt, Suite, Bldg. (optional)

City

State / Province / Region

Postal / Zip Code

Country

Preferred Phone

This phone number is for the main parent/guardian contact for the child. Please format XXX-XXX-XXXX (optional) ext.XXXX

Is this your:

HomeCellWork

Child's Name

Please include first name, middle initial, and last name

Child's Preferred Name

(optional) Child Phone

This is an optional field for the child. Please format XXX-XXX-XXXX

Child Email

Birthdate

Student Grade Level

School Name

Street Address

School (Street Address)

Apt, Suite, Bldg. (optional)

School (Apt, Suite, Bldg. (optional))

City

School (City)

State / Province / Region

School (State / Province / Region)

Postal / Zip Code

School (Postal / Zip Code)

Country

School (Country)

School Phone

School (Phone)

School Fax

School (Fax)

DLC offers tutoring in Math and English. Please select the desired tutoring subject below

MathEnglishBoth

Please select the days you wish for tutoring Please note that you may not be able to get all of your desired scheduling times.

MondayTuesdayWednesdayThursdayFridaySaturday

List your desired tutoring hours for the days selected above.DLC is open for tutoring Monday through Friday from 3pm – 7pm, and Saturday 9am – 7pm. Tutoring happens in increments of one hour.

Please list your desired times as: day, hour increment, subject (For example: Monday, 5-6, Math)

Any other comments you wish to provide DLC

Application Process

Tutoring Application

Parent/Guardian Information