new student registration

Please remember that we do have guidelines for in-home and online tutoring. These guidelines are in place to protect our tutees and to protect the integrity of our company. Thank you for agreeing to follow our guidelines

Student One

Personal Information

Student One

Challenge Subjects

Student One

Responsible Person(s)

Student One

Emergency Contact

Authorization Consent Form

Student One

Authorization: I hereby authorize Brainiac In-Home Tutoring LLC, and its representative(s) to contact my child's teacher(s) regarding his or her progress, assignments, grades or any other information necessary to assist with tutoring my child. I give my child's teacher(s) permission to release said information to my child's tutor.