FREE TUTORING
Free tutoring is offered:

**WEDNESDAYS from 4:00-7:00 PM at The Upper Room (129 W. Broad Street, Statesville)
**MONDAYS from 3:30-4:30 PM at Statesville Middle School
**WEDNESDAYS from 4:30-6:30 PM at The Statesville Recreation Center
**TUESDAYS/THURSDAYS from 3:30-5:30 PM at Shiloh AME Zion Church

Contact Anita Johnson at 704.996.1195 with questions or to receive more information.


Please fill out this form to register your child for tutoring.
Email address *
Select site for tutoring *
First Name of Student *
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Last Name of Student *
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School Student Attends *
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Age of Student *
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Grade of Student *
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Name of Parent/Guardian *
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Emergency Contact Phone Number *
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Please list the name(s) of anyone who has your permission to pick up your child. *
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Parent Email Address *
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Student Email Address
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Do you give permission for child's picture to be used on the webpage or news articles featuring the tutoring program *
Are there any medical conditions or allergies? If yes, list the condition/allergy below. If there are no allergies or medical conditions, please enter "No" *
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