In-Home Tutoring

Parent's Last Name: *
Parent's First Name: *

Home Address:



* State: * Zip: *
Email Address: *
Home Phone: *(eg. 5553331212 - no dashes)
Cell Phone: *(eg. 5553331212 - no dashes)
Student's Full Name: *
Age: *
Grade: *
School: *
Subject(s) *
Describe tutoring needs: *
Additional comments regarding student:

days and hours:
(check all that apply)
Day of Week 1st Time Preference 2nd Time Preference

Register for tutor service:
Please contact me:

TLC Tutoring Services
Client Understanding and Release:

Understanding between parties:

1. TLC for Kids, Inc. ("TLC") agrees to make its best effort to locate a suitable tutor upon request by the below signed client ("Client").

2. Rates:
TLC agency fees:
Client understands that a $200 non refundable deposit fee will be charged by TLC to secure the "first five" tutor visits and a TLC membership fee.

$55 per 1 hour session:*
. $35 paid directly to tutor at the end of each session
. $25 agency fee Charged to Credit Card

*10 session minimum

Client understands that TLC will charge a $25 per visit agency fee on client's credit card for all sessions based on current rates as listed above.

Client agrees to pay Tutor directly for services rendered at least $35 per hour

3. Cancellation Policy
A. Client understands that a non-refundable agency per diem fee ($25) will be charged to Client's credit card upon TLC's confirming Client's reservation for a Tutor.

B. If Client cancels a confirmed session within 24 hours of the scheduled visit, Client will be charged for one hour of the Tutor's time in addition to the agency reservation fee.

4. Client understands that the services provided by all TLC Tutors must be contracted through the TLC office. Client further understands that the use of a TLC Tutor or the referral of a TLC Tutor to a third party, without arranging the visit through TLC, is considered "theft of services" and will result in a charge of $1,800 in liquidated damages.

5. In the event that Client wishes to hire a Tutor on a permanent basis, TLC agrees to negotiate with Client in arriving at an acceptable placement fee. TLC's standard placement fee for a Private Educator is 10%-15% of the the Private Educator projected gross annual compensation, with a minimum of $1,800 for a part-time (under 40 hours per week) and a minimum of $2,500 for a full-time (40 or more hours per week).

6. Client understands that TLC Tutors are not employees of TLC. Client understands that Client may be responsible for withholding and filing employment taxes for each calendar year in which the Tutor's payments exceed the limits set forth in the Internal Revenue Code. Social Security numbers of caregivers must be obtained directly from Caregivers.

7. Client agrees to indemnify, release and hold harmless TLC, its agents, employees and officers for any and all claims relating to or arising out of the services provided by Tutors.

I have read and understand the terms of the agreement.

Credit Card Information:
Card Type: *       MasterCard ®         Visa ®         American Express ®         Discover ®  
Name as it appears on card:*
Card Number:*  
Expiration Date:* Month / *
IP Address logged as: