Student Enrollment Application
The Tutor Me Program (TMP) will be held from September 07, 2020 - Friday, May 07, 2021 . Due to COVID-19, TMP offers 1:1 tutoring/mentoring services. This program is offered to students grades K-12 with in St. Louis County and St. Louis City school districts.

The TMP provides academic enhancement services for 30 minutes per session twice a week. Each session is $15.00. We do work with families who has multiple children. The program is only provides free services to our partnering school districts. Our goal is to help your child to better understand subjects that are troubling to them. At this time, all sessions are held at our Administration Department, which is located in Bridgeton, MO.

One application per student. Remember that once you set and accept your child's 1:1 tutoring/mentoring sessions, then you are responsible for making sure that your child attends each session.There is a zero tolerance policy for no call/no show appointments. Parents/guardians must attend an Orientation before student is accepted into the program. Please review our website at www.smartkidsinc.org for more information.
Student Name: *
Student's Date of Birth: *
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Age *
Student's Current Grade: *
Name of School and District: *
School Address and Phone: *
Legal Parent/Guardian Name(s): *
Relationship to the student: *
Home Address, City, State, Zip:
Contact Number (Cell/Home): *
Email Address: *
Are you the legal guardian of this student and assume all responsibilities? *
Employer’s Name: *
Employers’ Address: *
City/State/Zip Code: *
Emergency Contact Information:
Please enter an emergency contact information for this student.
Name: *
Address: *
City/State/Zip Code: *
Contact Phone (Cell/Home): *
Your child's application must be completed before services can begin. Please be advised that your student will take both an Entry and Exist Assessment Exam as a part of our data collection report. Remember that once you set and accept your child's 1:1 tutoring/mentoring appointment, then you are responsible for making sure that your child attends his/her sessions. Students receive 2 sessions per week. There is a zero tolerance policy for parents/guardians that make appointments and do not show up for them.
Please check here for your consent to take pictures and video of your student’s participation in the program and to be used solely for media content. *
Required
Subject Strength(s): *
Subject Weakness(s): *
Subject Needing Tutoring In (Limit 1) : *
Does your child have a quiet place to study (if so, where?): *
Hours Spent on Homework a Night: *
Hours Spent Reading a Week: *
Does your child complete his/her homework studies near or in front of a: television, game system, radio, or any other entertainment that causes distractions? *
Is there any down time during the evening time where you can relax and read a good book, study, or complete your homework? *
Extracurricular Activities/Sports: *
Signature (Please type your name below): *
Date
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