Student Registration Student Registration 1Student Information2Parent Information3Weekly Availability 4Educational Information5Billing Information Student InformationStudent Name* First Last Date of birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email* Primary Contact Number*Secondary Contact NumberMailing AddressAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parent InformationMother's Name First Last Home NumberMobile NumberEmail Father's Name First Last Home NumberMobile NumberEmail Weekly AvailabilityMark slots available for tutoringMonday 8:00AM - 10:00AM 10:00AM - NOON 12:00PM - 2:00PM 2:00PM - 4:00PM 4:00PM - 6:00PM 6:00PM - 8:00PM 8:00PM - 10:00PM Tuesday 8:00AM - 10:00AM 10:00AM - NOON 12:00PM - 2:00PM 2:00PM - 4:00PM 4:00PM - 6:00PM 6:00PM - 8:00PM 8:00PM - 10:00PM Wednesday 8:00AM - 10:00AM 10:00AM - NOON 12:00PM - 2:00PM 2:00PM - 4:00PM 4:00PM - 6:00PM 6:00PM - 8:00PM 8:00PM - 10:00PM Thursday 8:00AM - 10:00AM 10:00AM - NOON 12:00PM - 2:00PM 2:00PM - 4:00PM 4:00PM - 6:00PM 6:00PM - 8:00PM 8:00PM - 10:00PM Friday 8:00AM - 10:00AM 10:00AM - NOON 12:00PM - 2:00PM 2:00PM - 4:00PM 4:00PM - 6:00PM 6:00PM - 8:00PM 8:00PM - 10:00PM Saturday 8:00AM - 10:00AM 10:00AM - NOON 12:00PM - 2:00PM 2:00PM - 4:00PM 4:00PM - 6:00PM 6:00PM - 8:00PM 8:00PM - 10:00PM Sunday 8:00AM - 10:00AM 10:00AM - NOON 12:00PM - 2:00PM 2:00PM - 4:00PM 4:00PM - 6:00PM 6:00PM - 8:00PM 8:00PM - 10:00PM Educational InformationEducational Institution Grade/Year/Level Course Type Semestered Non Semestered Other BRIEFLY DESCRIBE STUDENT'S CHALLENGESPlease include grade expectations/personal goals/career aspirations, and any other relevant information.WHAT DO YOU HOPE TO GAIN FROM ADDED SUPPORT?Please include grade expectations/personal goals/career aspirations, and any other relevant information.SUPPLEMENTARY DOCUMENTS PREVIOUS REPORT CARDS GRADE POINT AVERAGE AND GRADE HISTORY STANDARDIZED TESTING SCORES (EQAO, OSSLT, SSAT, SAT, ACT, GMAT, TOEFL, IELST) SAMPLES OF WORK INDEPENDENT EDUCATIONAL PLAN (IEP) PSYCHO-ED ASSESSMENT RESULTS STUDENT’S PERSONAL ESSAY RCM CERTIFICATION DOCUMENTS AWARDS/ACHIEVEMENTS PARENT’S ESSAY LETTER FROM PREVIOUS INSTRUCTOR File Attachment (PDF Format Only)Max. file size: 256 MB.* PDF Format Only * Use this Free Online PDF Converter CLICK HERE TO CONVERT YOUR FILES TO PDF Billing InformationName First Last Phone NumberEmail Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country ACADEMIC PACKAGE AD HOC ($60/Per Hour) $60.00 10 - HOUR PACKAGE (550.00) 15 - HOUR PACKAGE ($825.00) 20 - HOUR PACKAGE ($1100.00) 50 - HOUR PACKAGE ($2750.00) 110 - HOUR PACKAGE ($6000.00) Test Only - Admin's Only PREFERRED PAYMENT METHOD PAYPAL OR CREDIT CARD INTERACT E-TRANSFER CHEQUE Total $ 0.00 CAD If you pay by chequePlease address to Arcanum Educational Services Inc, place in the memo line, and mail to 220 Tom Taylor Cres. Newmarket, ON, L3X 3E8. If you opt for an E-transferPlease indicate Arcanum Academy as the recipient and use the email address: inquire@arcanumtutoring.com.EmailThis field is for validation purposes and should be left unchanged.
