Tutor Matching Questionnaire Take a few moments to tell us more about yourself and your student GradeKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeTest PrepCollegeSubject(s)*Topic you are struggling with (Be specific as to which class.)ZipcodeGuardian's Name First Last How are you related to the student?MotherFatherSiblingGrandparentWhat is YOUR (the guardian's) age?21 and Under22 to 3435 to 4445 to 5455 to 6465 and OverGuardian's Email* Guardian's Phone*Student's Name* First Last Student's Age*8910111213141516171819202122232425School Name*Student's Email What three personality traits would you or your child benefit from most in a tutor?*What languages do you speak in your household?*What days and times of the week would you like to meet with a tutor? Monday (8 am - 2pm) Monday (2pm - 3pm) Tuesday (8 am - 2pm) Tuesday (2pm - 3pm) Wednesday (8 am - 2pm) Wednesday (2pm - 3pm) Thursday (8 am - 2pm) Thursday (2pm - 3pm) Friday (8 am - 2pm) Friday (2pm - 3pm) Saturday (8 am - 2pm) Saturday (2pm - 3pm) Sunday (8 am - 2pm) Sunday (2pm - 3pm) How did you hear about us? Charter School / Private School / Public School Referral Google Instagram Pintrest Facebook Fliers Affilate Partners - Churches, Meetups other How can Genius Factory help you? I need a tutor urgently I need a tutor/mentor long term solution I need to sign up for an Assessment with a Genius Factory Academic Advisor I need to sign up for a session with an Academic Success Coach (College Applications/Scholarships/School Advising) I need a mentor for my child. I need a Genius Mentor who specializes in Anxiety, Depression, Lack of Motivation I need to sign up for a subject based review (Calc, Chem, Physics, Engineering, etc.... I need to sign up for Drop In Tutoring I need a tutor to come to my home I need help with Test Preparation (ACT, SAT, MCAT, DAT, GRE (In order for us to really serve you or your child it is important that you specify how we can help you)CommentsThis field is for validation purposes and should be left unchanged. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.