REGISTRATION FORM

Welcome to Alpha Reading Center Registration! 
Please fill out the following form.
FAMILY INFORMATION
STUDENT EMERGENCY CONTACT & PICK-UP AUTHORIZATION
If "No" provide those authorized for pick-up
PAYMENT INFO, TERMS & CONDITIONS
Credit Card Details
By submitting your credit card you consent the initiation of payments on your behalf that we provide to you and/or for services that you requested ahead of time.

1. Our elite programs differ vastly from others. Students in our programs will not just be “tutored,” but will be given personalized instruction to supplement classroom instruction, progressing step-by-step through the many levels necessary to attain comprehensive knowledge and skills according to their appropriate levels.

2. Parents/Guardians are greatly encouraged to review materials with their student(s) for 5-10 minutes daily in order to optimize results. Students differ in learning speed and ability. Some take more time than others to show progress. Maintaining a positive, supportive attitude toward the student will build confidence and a sense of accomplishment, which are important to academic success.

3. A typical hour-long session usually consists of 50-55 minutes of actual instruction time, depending on the student’s capacity to focus. A break will be given halfway through the session, or as needed. Likewise, a typical half-hour session usually consists of about 25 minutes of actual instruction time. The last five minutes of each session is dedicated to post-lesson debriefing and consultations with the parent.
4. Parents/Guardians are expected to pick up their student and meet with their student’s teacher five minutes before the end of the session for a brief consultation over the day’s instruction. If you have more questions or topics to discuss, please pick up your student closer to ten mintes before the end of the session. Parents may make arranagemets to sit-in on sessions with the student and teacher.

5. Payment is expected prior to receiving service. A current credit card must remain on file. Account will be charged after appointment requests by the parent has been approved by the teacher. Payments will be applied by the invoice due date. Any unpaid appointments will be dropped from the calendar. Only sessions that have been paid for at least two business days in advance will be scheduled. You can keep track of your payments, invoices, account information, and appointments online.

6. You are not asked to commit to a long-term contract. Students are encouraged to complete the entire program / school year, however, you are not obligated to do so. You can select your number of sessions.

7. Cancelations: Your child’s teacher blocks out his/her schedule and prepares ahead of time to teach your child. Please give 48 hours notice if you must cancel a class to receive a session credit for that missed session. Otherwise, a FULL session will be charged for canceling a class within 24 hours or for “no shows.” Same day cancelations will be charged a full session.
Illness: If a student has a communicable illness, please call as soon as possible and cancel the class to avoid exposing others to the illness. Please call in your child’s absence first thing in the morning to provide the teacher adequate notice. If the teacher is present for the session before you call, a full session will be charged.
Refunds: Canceled sessions will not be refunded. Session credits are given and must be used within 60 days from the cancelation. Unused sessions credits after 60 days of cancelation will not be scheduled and the session credit will no longer be applicable.

9. We reserve the right to terminate service for students who do not maintain regular attendance, for delinquent payments, or for failure to cooperate.

10. You are agreeing to receive an academic service. Certain schedules and/or teachers are not guaranteed and may vary throughout the student’s time at Alpha Community Learning Centers.

11. By signing this agreement you are also giving permission to allow photographs or video taken of your child for the use and purposes of promoting, teaching, and/or training for Alpha Community Learning Centers, Alpha Reading Center, and/or Academic Associates® Reading Program..

12. Alpha Community Learning Centers reserves the right to change any part of the terms or agreement at any time without notice.

13. Payments need to be received when requests are approved or schedule confirmed. This is before your child receives services and by the invoice due date or it is considered late. A current credit card is required to be on file in order to receive services.

14. Late payments will be assessed a fee in the following increments:
o 1-30 days: $10 fee
o 31-60 days: $25 fee
o 61-90 days: $50 fee
o Over 90 days: $75 fee + 10% interest on total amount due per month + any cost related to collecting payment

15. Credit card processing fee is 3.4% or the going rate per transaction.

STUDENT INFORMATION
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