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BROOKLYN LEARNING LAB STUDENT REGISTRATION FORM
Brooklyn Learning Lab thanks our parent/guardian for their interest in our FREE Mathematics tutoring " MATHEMATICS AND CULTURE ONLINE" based on the New York State Common Core Standards.

WE SEEK CHILDREN IN GRADES 3, 4 OR 5. Our SESSIONS OPERATE FROM MONDAY TO FRIDAY FOR 30 MINUTES.

WE ARE A GROUP TUTORING PROGRAM ONLY. SESSION ONE IS 30 DAYS IN LENGTH AND WILL FOCUS ON THE FOLLOWING TOPICS

1. WHOLE NUMBERS
2. FRACTIONS
3. DECIMALS

YOUR CHILD WILL NEED

1. A COMPUTER OR LAPTOP PLEASE NO MAC BOOKS, IPADS OR MAC COMPUTERS (at this time)

2. INTERNET, A WORKING WEBCAM, AND MICROPHONE

3. A PLACE AWAY FROM LOUD NOISES

DATES: START MONDAY, SEPTEMBER 25, 2017

END FRIDAY, NOVEMBER 3, 2017.

INFORMATION SESSION on Saturday, September 23, 2017

LOCATION: BUSHWICK GALLERY AND CREATIVE SPACE
ADDRESS: 1094 Broadway, Brooklyn, NY 11221.
TIME: 9:30 AM to 10:30 AM.

BRING: LAPTOP OR TABLET YOUR CHILD WILL USE FOR THE ONLINE TUTORING
RSVP: 2 SPOTS (CHILD AND AN ADULT)

THANK YOU FOR YOUR INTEREST IN BROOKLYN LEARNING LAB's ONLINE MATHEMATICS TUTORING "MATHEMATICS AND CULTURE ONLINE".

Email: Tricia Herbert at t.herbert@brooklynlearninglab.com for more information.

Email address *
Parent/Guardian Name *
First and last name
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Child's Full Name *
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Child's Grade *
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Does your child have an Individual Education Plan or IEP *
If YES, please explain what services your child is receiving and what problems the school explained your child will receive those services for.
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Home Zip Code *
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Why do you want your child to receive FREE Mathematics tutoring? *
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Time Slots: What time will your child be available to receive FREE Online Mathematics Tutoring? Please CHECK ONE box. *
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Parent Release Form For Child's Image or Text Produced Content. READ CAREFULLY BEFORE CHECKING BOX
I, as Parent/Guardian GRANT OR DENY permission to Brooklyn Learning Lab to use the image or text produced by my child during the Live Mathematics Tutoring sessions as marked by my selection(s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, text content and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Brooklyn Learning Lab website.
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Parent/Guardian Phone Number *
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Date *
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Attend Brooklyn Learning Lab's Informational Session on Saturday, September 23, 2017 at Bushwick Gallery and Creative Space: 1094 Broadway, Brooklyn, NY 11221 from 9:30 AM to 10:30 AM. (AT this time we can only RSVP 2 spot per family: the registered child and an adult attending with child). PLEASE BRING THE LAPTOP OR TABLET YOUR CHILD WILL USE FOR THE ONLINE TUTORING. *
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