Tutoring Service Request

"Goals" sits at the end of this form as an optional open text box, and it is often the answer that matters most: it tells you whether a family wants weekly homework support or an intensive push before an exam. The rest of the Tutoring Service Request template gathers everything else you need to place a student well, from contact details to scheduling preferences, in an estimated 5 to 8 minutes of the requester's time.

Nine fields, one clear picture of the student

The 9 fields start with the basics: the requester's full name and email are required, a phone number is optional. A separate Student Name field follows, because the person filling this out is usually a parent, not the learner. From there, four dropdowns do the matching work. Subject offers Math, Science, English, History, Test Prep, Language, and Other. Grade Level runs from Elementary through Middle School, High School, and College up to Adult. Session Type asks whether the family wants In Person, Online, or Either, and Frequency captures cadence, from once a week up to daily, with an As needed option for flexible arrangements.

The form spreads across four pages: a cover page, a content page, a payment page, and an ending page. It's set up to run in conversational mode, one question at a time, which suits parents filling it out on a phone between school pickups.

Who actually runs intake this way

Independent tutors use it to replace back-and-forth email threads with a single link. Tutoring centers route requests through it so a coordinator can match each student against tutor availability and subject expertise. Test prep companies lean on the Test Prep subject option and the Frequency field to spot students who need an intensive short-term schedule rather than ongoing weekly sessions.

Swap the subjects, keep the structure

Every dropdown option is editable. A language school can trim the Subject list to its own offerings; a music teacher can replace it entirely. Add fields if you need availability windows, drop the optional phone field if you never call, and put your own logo and colors on all four pages.

When it's ready, share the form by link or QR code, embed it on your site, or drop it into WordPress with the Uplup plugin's shortcode. Each request lands in your response dashboard with per-question breakdowns, exports to CSV, and can trigger webhooks or Zapier if you want new requests pushed into the tools you already use.