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ILLINOIS TUTORING INITIATIVE HIGH IMPACT SUMMER TUTORING CAMP STUDENT ENROLLMENT FORM
ITI Enrollment Form
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Email *
Student: First Name, Middle Name, Last Name *
Student's Address *
Student's school district email (has the district initials) *
County, District, School *
Date of Birth *
SIS ID #( this number is the student number from the district) *
Parent/Guardian Full Name
Parent/Guardian Email Address
Parent/Guardian Phone Number
Emergency Contact Name and Phone number
Grade Level
Recommended Tutoring Subject (Reading or Math)
Race/Ethnicity
Special Education 
ELL Primary Language
Choose Student Availability for Reading
Choose Student Availability for Math *
Required
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