Tutor Request Form 2020-2021

TUTORING SHEDULE:
- Monday | 2:30 p.m. to 4 p.m.
- Tuesday | 2:30 p.m. to 4 p.m.
- Wednesday | 11 a.m. to 4 p.m.
- Thursday | 2:30 p.m. to 4 p.m.
- Friday |2:30 p.m. to 4 p.m.

Student Name Student Name First Last
Grade / Year
Parent / Guardian Name Parent / Guardian Name First Last
Parent / Guardian Email
Phone Phone - ### - ### ####
Subject for Tutoring
Current Teacher
Current Grade in Class
If requesting tutoring for MATH, please complete the information below:
Course

Course Math 6 Pre-Algebra Algebra I Geometry Algebra II Pre-Calculus
If requesting tutoring for a subject OTHER THAN MATH, please complete information below.
Course
Peer Tutoring

Please indicate below the days and times you are available to get tutored.
Tutoring Format
Monday Monday : HH MM AM/PM
Tuesday Tuesday : HH MM AM/PM
Wednesday Wednesday : HH MM AM/PM
Thursday Thursday : HH MM AM/PM
Friday Friday : HH MM AM/PM
Parent / Guardian Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

Tutor Request Form 2020-2021

Tutor Request Form 2020-2021

If requesting tutoring for MATH, please complete the information below:

If requesting tutoring for a subject OTHER THAN MATH, please complete information below.

Peer Tutoring