Parental Application Form Applicant's NameRegionEthnicityGrade LevelAgeLanguage (1st)Child LanguageArea Needing AssistanceDoes your child need any special assistance?Does your child attend school? Which school does your child attend?Is your child receiving any services, tutoring classes, remedial services, etc., in or out of school?Days the child is availableTimesYour Name (Parent, Legal Guardian)Your AddressStateCityZip CodePhoneEmailConsent *The Parent, understands that our tutors are either graduates for an educational program, studying in an university for education, or can be substitute teachers without certification, pending certification and or licensure. This is a volunteer program that benefit not only your child but also the educator as it give them the experience in working with your child, and your child receiving the benefits. You are agreeing to release share solutions of all liabilities as we do not guarantee nor make any representation of any outcomes of the success of each child/tutor session or sessions. If you agree, please complete this form sign and date it and email it back to us, so that we are able to process your application and team your child with a tutor as soon as possible.Notes | Please add any notes you may think is helpful to us about your child.SUBMIT