Tutoring Request Form
The Staunton-Augusta-Waynesboro Tutoring Network offers academic support through free group tutoring sessions, thanks to volunteer tutors from the community. Tutoring will be provided remotely, through online platforms, and will be hosted and monitored through the Staunton-Augusta YMCA.
The weekly tutoring session schedule will depend on the availability of volunteers each week. There will be a limited number of spots in each session, so please be sure that if you sign up, your student will attend the session.
Please register using a PERSONAL EMAIL ADDRESS. This is critical, because at this time, we are not sure that students will be able to access the tutoring sessions from their school-issued Chromebooks or from their school email addresses. Each week, you will receive an email inviting you to register for that week's tutoring sessions.
If you would like to register multiple students, please complete a separate form for each student. Note that parent/guardian permission is required for participation.
if you have any questions!
* Please double-check that the email address you provided is NOT a school-issued email address. We are unable to send messages to school email accounts. Please use a personal email address instead.
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Phone Number
Student First Name
Student Last Name
Student's Current Grade Level
Would your student attend summer tutoring sessions, if offered?
Student's School (this helps our tutors to better understand what curriculum and software students may be using)
If your student was referred to this program by a specific teacher, please provide that teacher's full name here.
What is your student's primary/ native language?
Which of these subjects would your student like academic assistance with? (You may select all that apply here, but each week, your student may only register for one tutoring session.) PLEASE NOTE: Session schedule is subject to tutor availability, and there will be a cap on the number of participants per session.
Elementary Language Arts
Elementary Social Studies
Middle/ High School English
Middle/ High School History
Middle/ High School Earth Science
Middle/ High School Biology
Middle/ High School Chemistry
Middle/ High School Physics
Middle School Math (6th/ 7th/ 8th)
Middle/ High School Pre-Algebra
Middle/ High School Algebra 1
Middle/ High School Geometry
Middle/ High School Algebra 2
If you selected "Other," please specify which additional subjects you would like to see added. (Our ability to add subjects will depend on availability of tutors.)
Briefly describe your reason for seeking tutoring. This will help us to prepare our tutors.
What kind of device might your student use in order to access the tutoring session? You may select more than one.
Laptop/ Personal Computer
Other mobile phone or tablet
Chromebook (*please note that school-issued Chromebooks may not be able to access tutoring sessions)
Which would be the ideal day/ time of day for your student to attend a one-hour tutoring session? (Note: we cannot promise that sessions will be offered at your preferred time, but we'll take this information into consideration when scheduling.)
Weekday mornings (start time between 9:00am and 12:00pm)
Weekday afternoons (start time between 12:00pm and 5:00pm)
Weekday evenings (start time between 5.00pm and 8:00pm)
Weekend mornings (start time between 9:00am and 12:00pm)
Weekend afternoons (start time between 12:00pm and 5:00pm)
Weekend evenings (start time between 5:00pm and 8:00pm)
CONSENT AND LIABILITY RELEASE: As the parent/ guardian of this student, I hereby give my permission for this student to participate in the SAW Tutoring Network’s group tutoring sessions facilitated by the Staunton-Augusta YMCA (SAYMCA). By signing below, I indicate my understanding that my child will meet virtually with a volunteer tutor and a group of students, with a SAYMCA employee also present as a session monitor. My child will not be left to meet one-on-one with a tutor, nor will my child seek one-on-one meetings with a SAW Network Tutor outside of these sessions. I understand that these tutors are volunteers who have undergone extensive vetting by the SAYMCA, but that some tutors are not professional educators. I understand that tutors are committed to confidentiality of student information, but that my child’s screen name will be viewable to all in the session. I also understand that my child has permission to leave their video feed off during tutoring if needed or desired. By typing my name in this box, I am acknowledging the above statement.
Send me a copy of my responses.
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