Trend Literacy's 12-Week Reading Tutoring Program Interest Form
This form is to be completed by a parent/guardian who wishes to enroll their child/children in our reading tutoring program. Please allow up to 72 business hours to receive a phone call regarding your submission.
Parent/Guardian Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Child's Age/Grade
*
Has your child been enrolled in a tutoring program in the past? If yes, when?
*
Please list your child's reading struggles or areas in need of improvement.
*
Please list the two (2) best days and times you are available for a phone conversation.
*
When would you like your child to begin tutoring?
*
Submit
Should be Empty: