SOMS Achieve Tutoring Parent/Guardian Referral
To request an Achieve tutor for your student, please provide the information requested below and submit.

Achieve tutors (older students or adult volunteers from the community) are not professional teachers. They have received training conducted by the South Orange/Maplewood School District staff. If you would like your child to participate, please complete this form as soon as possible and submit.

Please note that since Achieve services rely on the number of volunteers available and scheduling factors, every effort will be made to match a tutor with your child, but there is no guarantee that a tutor can be assigned. You will be contacted by SOMS Site Supervisor Ms. Elson or Achieve Program Coordinator Amy Forman when a volunteer is available.

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Student's Last Name *
Student's First Name *
Parent's Phone Number *
Parent's Email Address *
My child can meet with a tutor (check as many as possible)
Achieve has my permission to use photographs of my child for publicity-related to the program *
Student's Grade Level *
Subject(s) and areas of focus *
Required
Additional comments and/or suggested activities/strategies for tutor:
I give permission for my child to meet on Zoom on Mondays or Thursdays at 3:15 pm. I understand that, in order for my child to participate, he/she must be cooperative, attend regularly, and arrive on time for weekly tutoring sessions. Achieve has my permission to use photographs of my child for publicity related to the program. *
Required
Write your full name below *
Provide your initials below to serve as an e-signature *
Submit
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