Hunter College Literacy Space Permission Form

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The Literacy Space provides free tutoring after-school, one day a week, from 4:30 - 5:45 pm.

Children in grades K - 8 engage in responsive literacy assessment and instruction, while working with a certified teacher on reading comprehension, word knowledge, fluency, and writing.

Currently, the program is online. Children in elementary grades attend for two semesters. Children in middle school attend for one semester.

*Tuesdays for elementary students, grades K - 5 (Section is now closed. Enrollment for September 2022 will begin in June.)

*Thursdays for middle school students, grades 6 - 8 (Section is now closed. Enrollment for February 2023 will begin in December.)

**In-person tutoring may begin in September 2022, at the Hunter College Campus West Building, room W938. This is subject to change.

The Literacy Space is committed to excellence and equity in literacy for all children.

* Applications are being accepted and children will be added to our waiting list.
** In-person tutoring may begin in September for all sessions.

Please complete all sections.

Email *

Date *

YYYY

Child's Name *

Child's Date of Birth *

YYYY

Child's Gender *

Female

Male

Nonbinary

Prefer not to say

Child's Ethnicity *

No, not of Hispanic, Latino, or Spanish origin

Yes, Mexican, Mexican American, Chicano

Yes, Puerto Rican

Yes, Cuban

Yes, another Hispanic, Latino, or Spanish origin (enter, for example, Dominican, Chilean, Salvadorian, Colombian, Guatemalan, Spaniard, Ecuadorian)

Other:

Required

Child's Race and Origin *

American Indian or Alaska Native (Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc.)

Black or African American (African American, Jamaican, Haitian, Nigerian, Senegalese, Malian, Ethopian, etc.)

White (French, German, Irish, English, Italian, Russian, etc.)

Chinese

Filipino

Asian Indian

Vietnamese

Korean

Japanese

Native Hawaiian

Samoan

Chamorro

Other:

Required

Grade Level *

Parent or Guardian's Name *

Street Address *

Apartment Number *

City/Town *

State *

Zip Code *

Phone Number (Best) *

Phone Number (Alternate)

Email *

Emergency Contact Name *

Emergency Contact - Relationship to Child *

Emergency Contact Phone Number *

Emergency Contact Email *

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