Brookline Tutor Mentor Program: Student Application 2019-2020
Welcome to the Brookline Tutor Mentor Student Application. To join our program, please fill out this form with as much detail as you can. We will be meeting every Sunday at the Brookline Teen Center from 2:00-4:00. Other times may be available.
Student's Full Name *
Your answer
Student's Pronouns *
Student's Grade *
Student's School *
Student's Hometown / Neighborhood *
Your answer
Parent/Guardian Full Name *
Your answer
Parent/Guardian Relation to Student *
Parent's Pronouns *
Parent/Guardian Preferred Email Address – One you check OFTEN *
Your answer
Parent/Guardian Phone Number *
Your answer
Emergency Contact Information (Name, Relation, Phone number) *
Your answer
Students: Have you been tutored with us before? *
If so, would you like to be paired with the same tutor as before?
Returning Students: What would you like your tutor to be like next year? What about your past tutor did you like/dislike?
Your answer
Returning Students: What about your tutor or the BTMP as a whole would you like to see change, if anything?
Your answer
Students: What academic areas do you need help in? *
Your answer
Students: What are your interests? List academic and after-school/extracurricular activities, hobbies, sports, and anything else you like! *
Your answer
How would you describe yourself? *
What type of a learner are you? How do you learn best? (Visual, Note-taking, Hands-on, etc) *
Your answer
Parents: What would you like your child to achieve? What would you like to get from this program? *
Your answer
The BTMP will be running on Sundays from 2-4pm at the Teen Center. Are you available at this time? If not, what days/hours of the week are you available to be tutored? Please elaborate on your schedule. *
Students: Do you speak a language besides English? If English is not your first language/you would rather be tutored in another language, please specify. *
Parents: If you would like to communicate in another language / if you want a tutor for your child that speaks a different language, please tell us here. *
Do you have any questions / Things you’d like to let us know?
Your answer
Thank you for applying to the BTMP!
Stay tuned and check your email for more information about introductory meetings and our start date!
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