VITAL Tutor Request Form (2023-2024)
In the VITAL Program, we are committed to ensuring that all of our tutors and participating families have the most productive and academically effective sessions as possible. We fully commit to providing families with the best tutors to leave tutees in more sound academic standings. Please note that this form is intended for families requesting a tutor.

VITAL will be offered as a hybrid program this year. You and your assigned tutor will decide what works best for your match.

Note: If you have multiple children who you are requesting tutors for, please fill out a separate form for each child.
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Email *
Student's First Name *
Student's Last Name *
Guardian's First Name *
Guardian's Last Name *
Primary Phone Number *
Please include area code.
Secondary Phone Number
Please include area code.
How do you prefer we communicate with you? *
Student's Grade Level *
The VITAL Program matches K-12 grade students from Appleton schools with the greatest academic need to Lawrence student volunteer tutors.
Subject Requesting Tutoring In *
Please select up to 2 subjects. For more information, please email us at community.engagement@lawrence.edu
Required
Please provide the name and email address of your child's teacher(s). *
Please indicate the subject each of the teachers are connected with if there are multiple.
Do you consent to your assigned tutor reaching out to your child's teacher(s) if they have additional questions or concerns? *
Best day(s) for tutoring *
Note: Tutors are excused from tutoring over scheduled Lawrence breaks and testing weeks.
Required
Best time(s) for tutoring

Please select all that apply.

Once you are matched with a Lawrence Tutor, you will be coordinating with them to find times to meet up. This is to get an accurate match with a Lawrence student.
 *
Required
Modality Preferences  *
The VITAL program will be hybrid this year, meaning that we will offer in-person and online tutoring. Please select which modality you are comfortable with, and if you are comfortable with both, please select "No Preference". We are trying to be as safe and accommodating as possible.

Students and volunteers who have been fully vaccinated may conduct their tutoring in the Warch Campus Center. Note that this is the only approved in-person location for tutoring. Unvaccinated students and volunteers must interact virtually.
Are you applying to VITAL because of the financial commitment involved with other tutoring programs? *
One of the goals of the VITAL Program is to aid those students who may not have the resources to pay tutors through other tutoring facilities.
Preferred Racial/Ethnic Background of Tutor**
**The VITAL Program asks Lawrence tutors for their racial/ethnic identity, foreign language fluency, and their gender identity to accommodate for the requests of the participating families. This is a part of our effort to best match students together. You are not obligated to answer any of these questions.
Preferred Spoken Language of Tutor**
**The VITAL Program asks Lawrence tutors for their racial/ethnic identity, foreign language fluency, and their gender identity to accommodate for the requests of the participating families. This is a part of our effort to best match students together. You are not obligated to answer any of these questions.
Clear selection
Preferred Gender Identity of Tutor**
**The VITAL Program asks Lawrence tutors for their racial/ethnic identity, foreign language fluency, and their gender identity to accommodate for the requests of the participating families. This is a part of our effort to best match students together. You are not obligated to answer any of these questions.
Clear selection
Please provide a short description of the student in need of tutoring. *
Examples: likes music, plays certain sports, favorite activities, etc.
Special Requests/Additional Information
How did you hear about VITAL? *
Required
Today's Date *
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