The Master Educators XChange
Client Registration Form
Today's Date:
Name:
Address:
City
State
Zip Code
Phone:
Email:
Geographical Location Where Services are needed:
What subject areas are our services needed?
What Grade Level is the student?
Are there any special services needed:
Please add reference information
Name:
Phone:
How long have you known them?
Please add a personal reference (relative)
Name of Personal Reference:
Relationship to you:
Phone:
Please Circle One:
Are you available:
Evenings
Weekends
All Days
If No, list days Available:
Hours Available:
In case of Emergency who should be contacted?
Name
Relationship
Phone:
Registration is $25.00 a year for processing and verifying qualifications. (which can be paid upon confirmation of services.)
Hourly rate for services rendered will be negotiated between Educator and Client. Payment will be made
with two checks: 1) 20% of total payment, to Steve White's Master Educator, and 2) the remainder of amount due, to the Educator.
I agree to the above conditions.
Signature:
Date:
Disclaimer: The Master Educator's Xchange is an Independent Contractor for any services rendered. All Educators are Independent contractors and must conduct themselves in high ethical and moral standards . All educators are responsible for their own behavior. Any educator who is found to not meet the high standards of the Master educator's XChange will automatically be dismissed from further service(s).
The Master Educator's XChange is not responsible for any unforeseen incidents that may occur while on location operating and or hiring through the Master Educator's Service. For those who would like to participate in a co-op community based pilot healthcare program for Independent Contractors and families who want to be covered for any health care matter. Information is available on BNJ. Look for "Alexander/McGee Medical CO-OP Foundation link.
