Request for after school tutoring through MI Kids Back-on-Track. EUE or EJSHS
Parent, legal guardian and student request formĀ 
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Student Last Name *
Student First Name
Parent / Guardian Last Name *
Parent / Guardian First Name *
Parent / Guardian Phone Number *
Student School of attendance *
Student Grade Level *
Area of need *
Transportation Needed *
If answered yes to transportation, please include address for drop off or pick up (summer school only)
Any other information the school may need to know?
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