Today’s Date
05-19-2021
Student’s Name
Kara White
Birthdate
10-31-2004
Parents’ or Guardians’ Names
Shandi and Cliff White
Street Address
5535 Grove Place Crossing
City
Lilburn
State
Georgia
Zip
30047
Parent/Guardian E-mail
shandi4@gmail.com
Primary Phone #
4043196121
Employer(s)
A.C. White Relocations
Work Phone (Mom)
4043196121
Parent’s Contact Cell phone
4043091918
Work Phone (Dad)
School student is attending now (if applicable)
Parkview High School
Grade Level
10
In what area(s) of academics are you seeking assistance?
in-person SAT and ACT preparation
(If school course) Textbook Title
ISBN#
If E-class and/or online textbooks, note here your USERID
PASSCODE
PARENT’S INITIALS
SEW
(If virtual sessions) SKYPE contact ID & phone #/email
770-480-2791, karaw4030@gmail.com
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?
NO
If yes, who, when, and in what area of academics?
Please circle days and times when this student can attend sessions:
Mon. Afternoon Evening
How did you hear about Total Learning Concepts or who referred you?
Sharon Sones
Conference dates and times:
PSAT/SAT/ACT Preparation Course: Monday evenings beginning 6/2021, 8 week course with pre and post testing
PSAT/SAT/ACT Preparation Course:
$100 deposit + $65 new student enrollment fee = $165