Student Appointment Form
Please complete form to register your child for homework help.
Student's Name
*
First Name
Last Name
Parent's Phone Number
*
Parent's Email
*
example@example.com
Subject(s) your child needs help with
*
English
Math
Reading/Reading Comprehension
Science
Spelling
Other
Grade
*
Please Select
K
1
2
4
5
6
7
8
9
10
11
Locations, Dates & Times
Each week, we are at 3 different locations. 1 location per day. Schedule based on day of the week and location.
Tuesdays @ the bin in Sandyville
Wednesdays @ Bridge Point in Canton South
Thursdays @ East Canton Elementary
Schedule
Should be Empty: