The Barefoot Tutor: Tutoring Request Form

"It is important that students bring a certain ragamuffin barefoot irreverence to their studies; they are not here to worship what is known, but to question it."

-- Jacob Bronowski, The Ascent of Man

Please fill out the form below if you are interested in tutoring provided by The Barefoot Tutor. Information is kept private and will not be used other than to respond to your request.

Student Name:

Contact Name:

Relation to Student:

Student Grade Level:

SUBJECT AREA(S) Math Reading English Science Social Studies/History Study Skills Other

Additional Information:

Street Address:

Zip Code:

Note: The Barefoot Tutor provides in-home tutoring services throughout Bucks County and Northeast Philadelphia (see map). Hourly Rates are based partially on travel distance, so please provide this information completely and accurately.

Contact E-mail:

Confirm E-mail:

Contact Phone:

Please fill out the form below if you are interested in tutoring provided by The Barefoot Tutor. Information is kept private and will not be used other than to respond to your request.

Your IP Address Will Be Recorded to Defend Against Frivolous Form Submissions.