I am not interested in having my child stay for tutoring at this time. If this is checked nothing else needs to be filled out.
Clear selection
Student Grade *
Required
Parent Name *
Your answer
Parent Contact Number *
Your answer
Emergency Contact Number (Must Be different from number above) *
Your answer
Parent Contact Email *
Your answer
Day(s) for student to stay for after school homework help *
Required
By Checking the box below I understand it is my responsibility to pick up my child at 4:30 pm from Myrtle Elementary School. I also understand that failure to pick my child up will result in my child's removal from the after school tutoring time. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Keystone Oaks School District. Report Abuse