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Tutoring Referral Form
Tutoring takes place in the LPP office in room 502A. After school tutoring is only available only on Mondays, Tuesdays, and Thursdays.
Student's name (first and last) *
Your answer
Name of staff member making referral *
Your answer
Staff email address?
Your answer
I would like to offer extra credit to students who consistently attend tutoring for my subject. *
What subjects are the reason for referral? Select all that apply. *
Required
What Regents does the student still need to complete? Select all that apply. *
Required
What days of the week is the student able to attend tutoring? Select all that apply. *
Required
What time of the day is the student typically able to attend tutoring? *
Required
What are the student's specific tutoring needs? Select all that apply. *
Required
Additional questions, concerns, or important information regarding the student?
Your answer
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