Consent form to request a peer tutor 2023-2024

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Students and their parent(s)/guardian(s) need to complete this form together. Please read carefully.

Parents/guardians: Please complete this form to provide consent and accept responsibility for your student to participate in 1:1 peer tutoring (in person and/or virtual format).

Expectations: Those requesting peer tutoring should be motivated, reliable, and have good classroom attendance. Reliable attendance with pre-arranged tutoring sessions is a requirement of the program. Any attendance and/or communication issues will result in removal from the peer tutoring program.

Sessions / Pairings: Students will meet regularly with their peer tutor once or twice a week at an agreed upon time. Students requesting a tutor will be paired with a suitable tutor by the Peer Tutoring staff. Staff will aim to pair students within a week of their request and will introduce the student to the tutor in person and/or by email. The students will then exchange contact information and determine a regular weekly schedule that works for both (ex. every Tuesday at lunch in the library).

Please note:

To be successful, students need to:

1. attend class regularly

2. complete and submit work

3. when needed, seek teacher help and/or access the help offered in the Academic Resource room (open before school, at lunch and after school each day).

** Peer tutors are an excellent resource in combination with other success strategies. Peer tutors are student volunteers and not trained educators. **

If you have questions about the peer tutoring program, please contact Ms. Coronado at lillian.coronado@ddsb.ca or Mrs. Whiteman at karen.whiteman@ddsb.ca

Email *

Student Last Name *

Student First Name *

Student Grade: *

Parent Last Name *

Parent First Name *

What is your preferred format for tutoring? (check all that apply) *

In person at lunch in the library or academic resource

In person after school in academic resource

Required

NOTE: Students and parents must be aware that ANY behaviour or comments that are deemed inappropriate or in violation of the School Code of Conduct will result in IMMEDIATE REMOVAL from the peer tutoring program and possible disciplinary consequences. Also, failure to attend pre-arranged sessions can result in removal from the program.

Parent Email to confirm consent to participate. *

Please list the courses & grade that your student NEEDS tutoring for: (example grade 9 math, grade 10 academic English, grade 11 college English) *

This form must be completed by both student and parent/guardian.

Did both student and parent/guardian complete the form together and review the eligibility requirements and expectations?

Yes

Anything else you would like us to know?

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Durham District School Board. Report Abuse

Forms