BSHS - Academic Assistance Lab, 2023-2024 Student/Parent Referral

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If you are a student who would like to receive additional support for a class or a parent who would like to refer their student for academic support services, please complete the form below.

Email *

Record my email address with my response

Person completing this form. *

Student being Referred (Last Name, First Name) *

Grade Level *

9th

10th

11th

12th

Course *

Reason for Referral *

Tutoring

Make-Up Work (due to absence)

Please explain how our in-house tutors can help you. If you just need time to work, "I need time to work." *

Date for requested assistance in the month of February *

2/1

2/6

2/8

2/13

2/15

2/20

2/22

2/27

2/29

Required

Send me a copy of my responses.

Submit

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