Student Information

Last Name.

First Name.

Birthdate (xx/xxx/xxxx)

Grade

Street Address

City

State

Zip Code

Phone (xxx-xxx-xxxx)

Our individual lessons are held at 1727 Arash Circle in the Waters Edge Development of Port Orange. Prices vary depending on the amount of hours purchased. All paid deposits are non-refundabler. Please use a separate registration form for each student.

Parents that request tutoring in the home may be charged an additional travel charge that will be negiotated depending on mileage and time.

Parents that wish to pay cash onsite, may make arrangements for such an option. The fee is negiotable.

Options

Chess Online using Zoom

One hour online zoom ($25)

(3) one hour discounted zoom lessons ($60)

Academic Lessons in Florida

I prefer to pay in cash each week in person at the negotiated rate.. ($30 - $40)

2 one-hour lessons .($60)

What subject or topic?

ADJUSTMENTS

Surcharge

Reason

Discount

Reason

Payment Information

Prices are subject to change without notice.

Our orders are processed by PayPal. Once your form has been submitted you will be forwarded to PayPal where you will then enter in your payment information. Do not press return until you are ready to order or your purchase will be duplicated at a later time.