Literacy in the Community Tutoring
WHAT: Please outline your students' academic problems/concerns and what you feel their needs are for academic support in the following box:
Your answer
WHAT grade is your student in?
Your answer
WHEN: When would you like to begin solving your academic concerns for your students?
Your answer
WHERE: Where is the best location to implement academic support/a tutoring plan?
Examples: In-Home, Local Library, Local Community Center, In-School, etc.
Your answer
WHY: Why is it important to gain help soon?
Your answer
HOW: How do you see academic support being implemented?
Examples: during school, after school, one on one, small groups, large groups, with siblings, etc.
Your answer
Do you have any questions you'd like us to address?
Your answer
Students' School District:
Your answer
Contact/Parent Name:
Your answer
Contact/Parent Phone Number:
Your answer
Contact/Parent Email Address:
Your answer
City, State and Zip Code:
Your answer
Are you interested in beginning tutoring for your student?
Yes
Maybe
Not at this time
Other:
How did you hear about Literacy in the Community Tutoring?
Received Postcard
Radio Commercial
Television Commercial
Other:
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