Elementary/Middle School Tutoring Request Form
Hello Families! Welcome to our NHS tutoring program. One of the essential foundations of our chapter of National Honors Society is tutoring, and we are excited to meet with anyone who needs some help in a class. Please fill out this form (and only this individual form) to sign up for a tutor. Fill this out ONE WEEK IN ADVANCE PLEASE. Thanks!

If you have any questions please reach out!
Pallavi Ploucha, Vice President of Scholarship : ploucha.pallavi74@bloomfield.org
Krista Laliberte, NHS Advisor : klaliberte@bloomfield.org
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Child's Name (Last, First)  *
Parents Name (Last, First) *
Parent's Email Address *
Parent's Phone Number *
Grade Level *
School *
General Subject you'd like tutoring in *
Specific content area ( if known) 
Teacher of the class you need tutoring in
How frequently would you like to meet with your tutor? (Please indicate if you would like to have an ongoing scheduled sessions,  a one time session, or on a need meet basis { test, exam etc} )
 *
Required
Do you have a convenient location in mind? (Starbucks, Library, via Zoom?) 
Please note any additional questions, concerns, or information you would like to inform our team about anything regarding your student or tutoring sessions.
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