USI Homework Help Assistance Form
Urban Strategies, Inc. would like to support school age children and parents with their distance learning needs during the COVID-19 pandemic. Our goal is to connect students with the support they need to stay on track while school learning is remote.

Please fill out this form to the best of your ability and we will be touch with you regarding educational resources, online tutoring opportunities, and more.
Who is this form being completed by? *
Required
Student's Name *
Your answer
Student's School *
Your answer
School District
Your answer
Student's Grade *
Student's Address: *
Your answer
Student's City: *
Your answer
Student's Email *
Your answer
Student's Phone Number
Your answer
Parent/Guardian Name and contact information *
Your answer
What is the primary language spoken?
What kind of work are you or your child struggling with? (Select all that are applicable) *
Required
What class are you or your child struggling with? (Select all that are applicable) *
Required
Do you or your child have any special learning needs? (ELL, IEP, ADHD, Dyslexia, Autism Spectrum Disorder, etc)
Your answer
Anything else you'd like to share?
Your answer
Submit
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