Student Application Form

Is {childsName} repeating the same grade as the 2023 -2024 school year?*

YesNo
Has {childsName} attended STAIR before?*

YesNo
If {childsName} is a returning STAIR student, if so when.*

Fall 2023Spring 2024Other
For Virtual Tutoring STAIR will provide one-on-one tutoring as well as all books and materials needed to participate. Students must have internet access and a desktop computer, laptop, iPad, or tablet with a camera in order to participate in tutoring sessions.*

Yes, my child does have access to the internet and a device with a camera.No, my child does not have access to the internet and a device with a camera.

Is {childsName} enrolled in any other after school activities?

YesNo
If the answer is yes, please enter the name of the program(s).
If the answer is yes, please explain any programs that might conflict with STAIR scheduling.
Is {childsName} enrolled in any other reading or writing programs?

YesNo
Please comment on any specific concerns regarding {childsName}.
i.e. Reading concerns, behavior, confidence, academic performance

Secondary Contact Name*

First NameLast Name
Secondary Contact Relationship to Child*
Secondary Contact Phone Number*
Secondary Contact Email Address*
example@example.com
How did you hear about STAIR?*

Friend or Co-WorkerChurchSchoolBack to School EventSocial MediaPrevious STAIR student or familyFlyerOther

Students Availability