AKR at the Library Interest Form

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Thank you for your interest in the AR Kids Read Summer Program being hosted at the Hilary Rodham Clinton Children's Library.

May 31st @ 4 pm is a kickoff meeting with pre-assessments. Tutoring starts the following week.

This exciting summer program will run from May 31st through July 26th, 2023.

Please fill out the form and you will receive a follow up email with next steps.

Email *

Parent/Caregiver Name *

Email *

Phone Number *

Student First Name *

Student Last Name *

What school district is your child currently enrolled in?

What school is your child currently enrolled in? *

What grade will they enter this Fall (2023)? *

1st

2nd

3rd

Does your child receive free or reduced lunch? *

Yes

What is your child's race/ethnicity? *

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Please share any information you would like AR Kids Read and their tutors to know about your child. *

I give permission to utilize photos taken during the program. *

Yes

I understand that in order for the tutoring program to be successful, consistent attendance is crucial.

Due to the demand and frequency of services, more than one absence could result in dismissal from the program. If a planned vacation would interfere with the program for any week, please contact info@arkidsread.org for direction.

Please type your name below if you understand and agree. *

What is your preferred time slot? *

Wednesdays 3pm - 4pm

Wednesdays 4pm - 5pm

A copy of your responses will be emailed to the address you provided.

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