Tutoring Student Participant Form
This is an initial one-time form for 8th grade students at the following schools:
> Hillside Middle School (Kalamazoo, MI)
> Linden Grove Middle School (Kalamazoo, MI)

Virtual Tutoring is held Wednesdays, 4p.m. - 6p.m. You're never late! Drop-in any time between the hours listed and get help even if it's for 30 minutes. We are here to help!

PARENTS: Please complete the form to receive a confirmation email with tutoring information and the Zoom link. The student participant information is collected by WMU MI GEAR UP for state grant funding purposes. Send us an email or call if you have questions: tania.echavarria@wmich.edu or (269) 397-3339.

For more information on WMU's Michigan GEAR UP Program visit: https://wmich.edu/precollege/gearup/about

For information on WMU's Office of Pre-College Programming visit: https://wmich.edu/precollege
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Email *
PLEASE NOTE: Students must sign-in to the tutoring Zoom link with their issued KPS EMAIL ADDRESS. Non-school issued email addresses will not be allowed into the virtual session for safety protocols. Virtual tutoring is recorded.
Student Email Address (must be issued KPS school email address)
Student First Name *
Student Middle Initial
Student Last Name *
Preferred Name
School Name *
Grade Level *
Gender *
Race/Ethnic Group *
Date of Birth (MM, DD, YYYY) *
Current Mailing Address (Street Address, City, Zip) *
Parent/Legal Guardian Phone Number *
Parent Consent Signature
(Parent/Guardian Electronic Signature) Please type full first and last name below
As the parent and/or legal guardian of the student listed above, I authorize and permit my child to participate in the WMU Michigan GEAR UP Virtual Tutoring  Group Sessions conducted by the WMU MI GEAR UP Program and the Office of Pre-College Programming at Western Michigan University. I understand that the virtual sessions will be recorded for student and staff safety. By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. My signature below indicates that, to the best of my knowledge, the information given on this application is true, complete, and accurate. *
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