☀️Summer Tutoring Interest Form
Hi! I’m Erin (Bivans) Henley and I am a licensed teacher with 30 years of experience working with children. I specialize in helping students stay sharp over the summer, strengthen skill gaps, and build confidence heading into the next school year. Many students lose up to 20–30% of academic progress during summer break. Some families seek tutoring for specific support, while others simply want to maintain strong habits and preview next year’s expectations. I support both needs through encouraging, structured, individualized sessions. Summer tutoring runs June 8 – August 6 (no sessions the week of June 22). Sessions are typically held at the Family Fare seating area off 10 Mile in Rockford. In-home tutoring may be available with a travel fee. If you are interested in tutoring, please complete the short form below. Sessions are 40 minutes and $40 per session. Full program details, scheduling, and payment structure will be shared after form submission. I look forward to learning more about your child! 🙂
Personal & Contact Information
Please make sure all information is accurate
Student's Name
*
First Name
Last Name
Parent's Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Student’s Birthdate
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Where did your child attend school for the 2025-2026 school year?
*
Grade level completed (2025-2026)
*
Please Select
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Subject for Tutoring
Please Select
Nothing specific. Just summer review!
Elementary Math
Reading/Phonics
Spelling
Handwriting
Writing
Algebra
Geometry
Multiple Subjects
Other
Frequency
Please Select
Once per week
Twice per week
Three times per week
Other
ADDRESS (if requesting in-home tutoring)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What days/times work best this summer? Check all that apply.
Tuesday 12:45pm (Family Fare)
Tuesday 1:30pm (Family Fare)
Tuesday 2:15pm (Family Fare)
Tuesday 3pm (Family Fare)
Tuesday 3:45pm (Family Fare)
Tuesday 4:30pm (Family Fare)
Thursday 12:45pm (Family Fare)
Thursday 1:30pm (Family Fare)
Thursday 2:15pm (Family Fare)
Thursday 3pm (Family Fare)
Thursday 3:45pm (Family Fare)
Thursday 4:30pm (Family Fare)
In-Home: fill out your specific day/time requests below (travel fee applies)
Other
Anything else you’d like me to know? Please share any schedule preferences, vacation dates, learning goals, or other helpful details so I can best plan for your child.
Submit
Should be Empty: