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Tutoring & Intervention Student Interest Form
Please complete this form if you are interested in having your child participate in tutoring/intervention sessions.
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* Indicates required question
Email
*
Your email
STUDENT'S LAST NAME
*
Your answer
STUDENT'S FIRST NAME
*
Your answer
GRADE LEVEL
*
6
7
8
STUDENT'S LAUSD EMAIL
*
Your answer
PARENT'S EMAIL
*
Your answer
INDICATE WHEN STUDENT CAN ATTEND
*
AFTER SCHOOL DURING THE SCHOOL WEEK ONLY
SATURDAY ONLY
BOTH: DURING THE SCHOOL WEEK AND SATURDAY
WHICH SUBJECT(S) WOULD STUDENT LIKE TO ADDRESS?
*
MATH
ENGLISH
BOTH MATH AND ENGLISH
Math Teacher's Name (if requesting help in Math)
Your answer
Which period does the student have Math?
Per. 1
Per. 2
Per. 3
Per. 4
Per. 5
Per. 6
Clear selection
English Teacher's Name (if requesting help in English)
Your answer
Which period does the student have English?
Per. 1
Per. 2
Per. 3
Per. 4
Per. 5
Per. 6
Clear selection
WHY DOES STUDENT NEED TO PARTICIPATE (MATH/ENGLISH)?
*
INTERVENTION- STUDENT NOT PERFORMING ON GRADE-LEVEL (GRADES D, F IN CLASSES)
NEEDS MORE TIME TO PRACTICE (GRADES B/C)
ACCELERATE AND ADVANCE THEIR LEARNING (GRADES A/B)
COMMENTS OR QUESTIONS YOU WISH THE STAFF TO ANSWER?
Your answer
Send me a copy of my responses.
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