Today’s Date
06-02-2021
Student’s Name
Helene “Callie” Sones
Birthdate
06-12-2021
Parents’ or Guardians’ Names
Sharon Sones
Street Address
874 Newcastle Drive SW
City
Lilburn
State
GA
Zip
30047
Parent/Guardian E-mail
seharrow@hotmail.com
Primary Phone #
7705967918
Employer(s)
Atlanta VAHCS
Work Phone (Mom)
7705967918
Parent’s Contact Cell phone
7705967918
Work Phone (Dad)
7704031342
School student is attending now (if applicable)
Parkview High School
Grade Level
Rising 11th
In what area(s) of academics are you seeking assistance?
Language Arts
(If school course) Textbook Title
ISBN#
If E-class and/or online textbooks, note here your USERID
PASSCODE
PARENT’S INITIALS
SES
(If virtual sessions) SKYPE contact ID & phone #/email
If the student has any learning differences about which we should be aware, please explain
Have you ever used a tutor or learning center before?
Yes
If yes, who, when, and in what area of academics?
Kirk Sones Study Skills Class
Please circle days and times when this student can attend sessions:
Tues. Afternoon Evening, Sun. Afternoon
How did you hear about Total Learning Concepts or who referred you?
Word of mouth
Conference dates and times:
Wednesday and Friday after 3 pm
PSAT/SAT/ACT Preparation Course:
$100 deposit + $65 new student enrollment fee = $165