SPMA Tutoring/ Mentoring Registration Form SY 2022/ 2023
We are excited to announce that Samuel P. Massie Tutoring and Mentoring sessions will begin on January 10th. Sessions will be held weekly from 2:45-3:45 pm. Each session will accommodate no more than 12 students. Register now before spaces fill up. If you are interested please complete the questions that follow. 
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Email *
Student Name (Full Name) *
Student Grade *
Parent Name (Full Name) *
Parent Email Address *
Parent Phone Number (s) *
Emergency Contact Person *
Emergency Contact Relationship to Student *
Emergency Contact Email Address *
Emergency Contact Phone Number (s) *
Which session would be your FIRST CHOICE to participate in? *
Which session would be your SECOND CHOICE to participate in? (optional) *
When your child is chosen to participate how will they go home after tutoring is finished? *
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