King George High School After School Tutoring Request Form for Students & Families
Please fill out this form if you would like to participate in the after school tutoring program or if you have a child that you would like to have participate. If there is more than one student in your family, please fill out a form for each student.
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Email *
I am making this request for... *
The first name of the student I would like to participate in this program is... *
The last name of the student I would like to participate in this program is...
 *
This student is in grade... *
The class(es) this student is requesting help with is/are... *
Required
At this time, after school tutoring is free but transportation is not provided. Tutoring begins at 2:45 and ends at 4:15. Are you able to arrange transportation at 4:15 for this student? *
How will this student be getting home at 4:15? *
In order for a student to participate, we need the name and contact information for at least one parent or guardian to verify that the student has permission to participate, has transportation arranged, and to facilitate ongoing communication with families.

The name of the parent/guardian responsible for communication with the Academic Support Program will be...
 *
This person's relationship to the student is... *
In order for a student to participate, we need the name and contact information for at least one parent or guardian to verify that the student has permission to participate, has transportation arranged, and to facilitate ongoing communication with families.

The phone number(s) of the parent/guardian responsible for communication with the Academic Support Program will be...
 *
In order for a student to participate, we need the name and contact information for at least one parent or guardian to verify that the student has permission to participate, has transportation arranged, and to facilitate ongoing communication with families.

The email address(es) of the parent/guardian responsible for communication with the Academic Support Program will be...
 *
Is there anything else you would like us to know about this student or do you have any questions?
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