IHELP Youth Application
Dear parent or guardian, Your child is eligible to participate in a free in-home tutoring program to improve their English skills. In our program, each child spends two hours each week with a tutor outside of school hours who will either come to your home or teach your child virtually. To participate, a parent or guardian must be present in the home during your child’s tutoring sessions. Your child’s tutor will be a trained, caring adult who has volunteered to help. Immigrant Home English Learning Program (IHELP) tutors are over the age of 18, receive a background check, and want to make a meaningful contribution to their community. They are part of IHELP, a local not-for-profit organization that provides individualized English-language tutoring to adults and children in grades Pre-K-5th. If you are interested in having your child participate in IHELP Youth, please complete the form below. By giving your phone number to IHELP you agree to receive periodical text messages that relate to your participation with IHELP. You may reply STOP at any time to opt-out. Please be aware that filling out this form does not mean you are enrolled in the program. An IHELP staff member will contact you for an English assessment after completing this form. Paper copies of this form are available as needed, please contact IHELP if you would like a paper copy or require assistance completing any portion of the form. Thank you very much.
Student Name
*
First Name
Last Name
Student Date of Birth
*
-
Month
-
Day
Year
Date
Student Language(s)
*
Home Country of Student
*
Student Street Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 1 Name
*
First Name
Last Name
Home Country of Parent/Guardian
*
Parent/Guardian Language(s)
*
Parent/Guardian 1 Phone Number
*
Please enter a valid phone number.
Parent/Guardian 1 Email Address
*
example@example.com
Parent/Guardian 2 Name
First Name
Last Name
Home Country of Parent/Guardian
Parent/Guardian Language(s)
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Parent/Guardian 2 Email Address
example@example.com
Most of our classes take place in the student's home or virtually, but some pairs prefer to meet at a neutral location like a library. Where are you interested in having your classes?
*
In home
Virtual
In a library
What days and times would be best for classes? (Not during school hours)
*
Would you like us to call, email, or text you?
*
Call
Email
Text
Should we contact you in English or another language?
*
English
Spanish
Other
Student's School Name
*
Student's Grade in School
*
How did you hear about us?
*
Student's school
Friend
Other IHELP Program
Online
Other
I, the undersigned parent or legal guardian of the student named above, do hereby consent and agree that the above named student may participate in the IHELP Youth Learning Program.
*
Continue
Continue
Should be Empty: