Unique ID

The Québec Board of Black Educators

Fall 2024 In-Person Tutoring Registration

Start of fall session October 2024: Tuesday, September 17, 2024

Membership Fee: $75
Monthly payment : $125

Our Offers Include:

A Supervised workspace and homework assistance
Students can drop by during our opening hours to benefit from academic support and a supervised study space.

Personalised Academic Support:
If needed, you can request the services of a tutor for individual tutoring sessions, available both in-person and online, tailored to your child's learning goals. These sessions are offered at competitive hourly rates.

Exam and Test Preparation Packages:
We also offer flexible packages specifically designed to help your children effectively prepare for exams and tests, so they can approach them with confidence and success.

Operating Hours:
Tuesday: 3:00 p.m. – 6:00 p.m.
Wednesday: 1:00 p.m. – 5:00 p.m.
Thursday: 3:00 p.m. – 6:00 p.m.
Saturday: 10:00 a.m. – 2:00 p.m.

Are you a member of the QBBE?*

Yes

No

Please enter your membership email*

PART 1: PROGRAM OPTION

Select the service(s) you want to register for:

Program Option*

High School Academic Support

Elementary Academic Support

CONTACT INFORMATION

Student Information / Information étudiant

Which Organization referred you?*

Name*

Last Name First Name

This field is hidden when viewing the form

Registration Email

This field is hidden when viewing the form

Portal Username

Address*

#civic, street Apartment City Province Postal Code

Date of Birth*

Gender*

M

F

Documents upload

(including Individual Education Plan (IEP), Report Card, Speech-Language Pathology Test, other relevant assessments)

Drop files here or

Accepted file types: doc, docx, pdf, jpg, gif, png, Max. file size: 64 MB.

Choose your school board*

School*

Cellular No

Email address*

CONTACT INFORMATION CONTINUED

Parent Information:

Parent*

Father

Mother

Guardian

Name*

Last Name First Name

Address same as student?

Yes

Address*

#civic, street Apartment City Province Postal Code

Home Phone*

Cellular No.

Email address*

Add Another Parent/Guardian?

Yes

Parent*

Father

Mother

Guardian

Name*

Last Name First Name

Same address as above?

Yes

Address

#civic, street / #civique, rue Apartment City Province Postal Code

(if different from the above one)

Home Phone*

Cellular No.

Email address*

MEDIA RELEASE CONSENT FORM

I hereby give the Quebec Board of Black Educators (QBBE) the right and permission to record my image or likeness while I participate in the Project/Event identified below. Furthermore, I hereby irrevocably give QBBE the right and permission to use my image or likeness so recorded.

QBBE’s right of use shall include the right to publish, adapt, exhibit, reproduce, edit, distribute and display my image or likeness in connection with any product or service for any purpose (including marketing, promotion advertising and trade) in all markets, media or technology now known or hereafter developed.

For certainty, and without limiting the above, QBBE’s right of use shall also allow it to publish my image or likeness on the internet, incorporate my image or likeness into promotional videos and share my image or likeness with media organizations for any purpose.

I shall not have any entitlement to compensation for QBBE’s recording and use and shall not make any claim against QBBE, its affiliates, agents, event partners, governors, officers and/or employees for damages that may arise from its recording or use including, without limitation, any claim that is based on an alleged misrepresentation, negligence, defamation, breach of privacy, right of publicity infringement or an infringement of any applicable privacy legislation.

By signing my name, I acknowledge that I have read, understand and agree with the contents contained within this Consent and Release.

If under 18 years of age, a signature of a parent or guardian is required. I acknowledge that I have read and understood this Consent and Release. I agree to its terms in connection with the photographic or electronic records of the likeness of my child:

Select the platforms you wish to give permission for use:

I grant QBBE permission to use my image or likeness on QBBE’s Website
I grant QBBE permission to use my image or likeness on the QBBE Newsletter & Official Reports
I grant QBBE permission to use my image or likeness on the QBBE Facebook page
I grant QBBE permission to use my image or likeness on the QBBE Instagram page

Project/Event: Fall 2021 Academic Support

Child Name

First Last

Parent or Guardian's Name

First Last

Disclaimer

If you chose the subscription payment option your credit card will be debited every month for a maximum of 4 payments or until your child concludes their support.

Total

Credit Card

Cardholder Name

Card Details

Comments

This field is for validation purposes and should be left unchanged.

The Québec Board of Black Educators

PART 1: PROGRAM OPTION

PART 2: COURSE SELECTION

High School Academic Support

Elementary Academic Support

Payment Information

CONTACT INFORMATION

Student Information / Information étudiant

CONTACT INFORMATION CONTINUED

Parent Information:

MEDIA RELEASE CONSENT FORM