Today’s Date
02-15-2021
Student’s Name
Siniet
Birthdate
10-13-2003
Parents’ or Guardians’ Names
Tsigereda Tarekegn
Street Address
1459, Hickory Ln Sw
City
Lilburn
State
GA
Zip
30047
Parent/Guardian E-mail
winsin12@gmail.com
Primary Phone #
4048342481
Employer(s)
Emory hospital
Work Phone (Mom)
7705407964
Parent’s Contact Cell phone
7705407964
Work Phone (Dad)
4042144801
School student is attending now (if applicable)
Parkview High School
Grade Level
11th
In what area(s) of academics are you seeking assistance?
Sat/Act practice
(If school course) Textbook Title
ISBN#
If E-class and/or online textbooks, note here your USERID
PASSCODE
PARENT’S INITIALS
TT
(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?
I was tutored at Kumon doing academics such as reading and math on Stone Mountain high way from 2015 - 2018.
Please circle days and times when this student can attend sessions:
Sun. Afternoon
How did you hear about Total Learning Concepts or who referred you?
Sabrina Eyasu referred me to Total Learning Concepts .
Conference dates and times:
Thursday at 4
PSAT/SAT/ACT Preparation Course:
$100 deposit + $65 new student enrollment fee = $165