OPTIMUS LEARNING SCHOOL

INQUIRY FORM

OPTIMUS LEARNING SCHOOL

INQUIRY FORM

Student's First & Last Name

Parent's First & Last Name

Email Address

School

Grade
*If you are inquiring about our summer program, please select the grade that your student will be entering in the Fall.

Phone Number

Which of the following programs do you want to enroll your child in?

After School Program Summer Camp

Private Lesson (1:1 Tutoring) Semi-private Lesson

Group Class GATE(1:1 Tutoring) AP Classes SAT Prep

Piano (1:1 Lesson) School Break

How many lessons (hours) per week:
Preferred day and time (i.e. Monday 3-4pm or Tuesday 5-6pm):

Day: Time:

Would you like to add another lesson?

Please specify a subject for private lesson (1:1 tutoring):

How many lessons (hours) per week:

Would you like to add another lesson? Yes No

Do you need a pick-up service? Yes No

OLS After School Program With Pick Up

Number of Days/Week	K-6th	7th-8th	9th-12th
5 days (Mon, Tues, Wed, Thurs, Fri)	$700	$750	$800
4 days (Any 4 days/week)	$650	$700	$750
3 days (Any 3 days/week)	$550	$600	$650
2 days (Any 2 days/week)	$450	$500	$550

OLS After School Program Without Pick Up

Number of Days/Week	K-6th	7th-8th	9th-12th
5 days (Mon, Tues, Wed, Thurs, Fri)	$600	$650	$700
4 days (Any 4 days/week)	$550	$600	$650
3 days (Any 3 days/week)	$450	$500	$550
2 days (Any 2 days/week)	$350	$400	$450

*Student pick-up/drop-off is based on availability and students enrolled in our After School Program for 5 days will receive priority.

Schedule	Day & Time	K-6th	7th-8th
Schedule A	M-Th 9-12 pm	$175	$200
Schedule B	M-F 9-12 pm	$200	$225
Schedule I	M-Th 9-3 pm	$200	$225
Schedule II	M-Th 9-6 pm	$225	$250
Schedule III	M-F 9-3 pm	$225	$250
Schedule IV	M-F 9-6 pm	$250	$275

Are you inquiring for more than one student? Yes No

Student's First and Last Name

School

Grade
*If you are inquiring about our summer program, please select the grade that your student will be entering in the Fall.
Would you like to inquire about another student? Yes No