Request edit access
Virtual Tutoring Registration (Student) 2020-2021
Please use this form to register your child for virtual tutoring. We will collect demographics for data collection purposes only. This information will be kept confidential.
Email *
Student's First and Last Name: *
Parent/Guardian First and Last Name: *
Parent/Guardian contact number *
Physical Address: *
Please record the email address you will use for the Zoom tutoring session. We will need a standard email address that can be used for every call. *
What school does your child attend? *
Does your child receive free or reduced lunch? *
What is your child's race/ethnicity? *
What grade is your child in? *
What enrollment term(s) would you like to register your child for? *
What day and time would you like your child to receive virtual tutoring? (Virtual tutoring sessions occur for 40 minutes weekly) *
I give permission to AR Kids Read to utilize photos and/or videos of my child for promotional purposes. *
"By typing my name below, I give consent for my child to participate in AR Kids Read virtual tutoring. I acknowledge that my child's sessions will be recorded for their safety and security." *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy