Tutoring Registration Form (Literacy Corps) NDCAC Fall 2018
After School Tutoring Program for Students 2nd-5th Grade
Student's Name *
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Student's Date of Birth: *
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Parent/Guardian Name: *
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School: *
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Grade: *
Teacher's Name: *
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My student's main language is: *
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Other languages spoken at home: *
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Address: *
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City: *
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Zip: *
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Phone: *
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Cell Phone: *
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Email: *
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I wish to enroll my student in Literacy Corps Tutoring at the Notre Dame Center for Arts and Culture. I understand I will be part of the goal-setting for my student, and I will need to pay a one-time fee of $25 for the semester. I will try to ensure that he or she will attend all sessions. I will keep all contact information up to date. Parent/Guardian Signature: *
Your answer
Date: *
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