Apply to be a student

Child's Name

First Last

Is the child a resident of Windsor, CT, USA?*

Yes
No

Participants in this program are required to be residents of Windsor.

Parent/Guardian Name*

First Last

Parent/Guardian Name (2)

First Last

Address*

Street Address City State ZIP Code

Email*

If none, type N/A

Preferred Phone*

Phone Type*

Phone – Home
Phone – Cell
Phone – Work

Hidden

How would you like to be tutored?*

In Person
Virtually

Grade level of student*

Child's School*

Area of Help Needed*

English
Reading
Math
General Homework Help

Availability (please choose all slots that work for you, we will use this to find you a match with similar availability)*

How did you learn about the program?*

Other information you'd like us to know

Photo Release Form

Occasionally we take photographs we take photographs during the program and at special events. To give your consent to use these photos on social media and other library-related communications, please download the form here*. Please email completed forms to [email protected] or drop them off in person.

Security Question*

What color is the sky? (rhymes with blue)

Comments

This field is for validation purposes and should be left unchanged.

Tutoring Student Application

Photo Release Form

Pin It on Pinterest