Student Application

If you have any questions regarding the application process, please email: info@basecamptutors.ca

---

Student Info

First Name

Last Name

---

Primary Contact

First Name

Last Name

Email Address

Mobile Phone #

Other Phone #

Address

Suite/Unit #

City/Town

Province/State

Postal/ZIP

Country

Nearest Major Intersection

---

Billing Info

First Name

Last Name

Address

Suite/Unit #

City/Town

Province/State

Postal/ZIP

Country

---

Education Info

Current School Attending

Current Grade

Please Select JK SK 1 2 3 4 5 6 7 8 9 10 11 12 College University Post-Grad Adult Learner

Describe the areas of difficulty that the student is experiencing.

---

Schedule Info

Please indicate if you’re looking for virtual or in-person tutoring? If you are flexible, let us know that too!

Provide the ideal times that the student prefers tutoring to take place.

How many days per week would you like tutoring?

Please Select 1 day a week 2 days a week 3 days a week 4 days a week 5 days a week 6 days a week 7 days a week

Where did you hear about Base Camp Tutors?

Submit your registration