2024-2025 DCMS Tutoring/Homework Help Sign Up Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Delphi Community Middle School will be offering free homework assistance on Wednesdays from 3:20 PM until 4:30 PM. It will begin on Wednesday, September 4, 2024. Please fill out the information below to sign your student up for homework assistance at DCMS.

**All students must be signed up before they can attend.. If your child can not be picked up by 4:30 PM or if a permission slip is not submitted, your student will not be permitted to stay. Students who are not picked up in a timely manner will not be allowed to stay after school.
**Expectations:
Please review the following Student Expectations BEFORE your student attends their first tutoring session.
1. Students should bring assignments they need help with and homework to work on.
2. Students are expected to work on assignments and ask questions as needed.
3. Students may not listen to music or watch videos while attending tutoring.
4. Student may bring a snack and/or drink for consumption after school, before tutoring begins.
5. Student must be picked up from tutoring by 4:30 PM or they will not be able to attend tutoring.

Email *

Student's First and Last Name: *

Student's Grade: *

6th Grade

7th Grade

8th Grade

Subject(s) needing extra help: *

Reading / Writing / Language Arts

Math

Science

Social Studies

Other:

Required

Parent Name/Signature: *

(By typing your name in the box below, you are giving permission for your student to stay after school for tutoring.)

Parent Email: *

Parent Phone Number: *

(For your child's safety, you will be contacted if your child is signed up to attend tutoring but does not attend or if there is a discipline issue.)

Name of an Additional Emergency Contact: *

(Please type the name of someone we can contact in the event of an emergency.)

Emergency Contact Phone Number: *

(Please type the phone number of the person listed as your student's emergency contact.)

How will your student get home from tutoring? *

My student will be picked up by a parent.

My student will be picked up by a relative or family friend.

My student will ride home with another student.

My student will walk or ride his/her bike home.

Other:

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Delphi Community School Corporation. Report Abuse

Forms