Tutoring Enrollment Form
Please fill out this form in order to apply for enrollment in the HHYC tutoring program. REMEMBER, filling out this form does NOT ensure your child will receive a spot in our program. Our director will reach out to you upon receiving your application, so please make sure all contact information is correct and up to date.
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What is your name? *
What is your phone number? *
What is your email address? *
What is your relationship to the student? *
What is your student's name and grade? *
What school does your child attend?
What is the student's subject of need? *
Please take time to describe your student's classroom needs. Are they failing, do they lack motivation, do they have a learning disorder, etc? What do you believe their need for tutoring is?
How often does your student wish to be tutored? *
What is your student's availability? Please state DAYS AND TIMES in which your student will be available to receive their tutoring. *
Tutoring is set to take place in Cottonport at the Helping Hands academics office, does your student have reliable transportation to this site? *
The full tutoring fee is $16 per instructional hour. If you cannot afford this fee, you are invited to apply for financial aid. If you do not apply for financial aid prior to the first tutoring session, you will be held liable for the full tutoring fee. Do you understand and agree? *
Considering the statements above, do you have any questions regarding the tutoring process or fees involved? *
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