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Student Application 2021-2022

Complete one application per child.

Please have the following information ready while completing this application: 
  • Student’s school information
  • Student’s academic needs
  • Family financial information
  • Emergency Contact information
During the 2021-2022 school year, Tutoring Chicago will offer in-person or digital tutoring options to students. Within this application you will have an opportunity to tell us more about your student’s needs and preferences. Our staff will do our best to accommodate the preferences of our students, but in some cases we may not be able to accommodate all preferences due to limited capacity of physical space or volunteer availability.

If your student is applying to Tutoring Chicago for the first time, they must be in 1st-6th grade. Tutoring Chicago will not accept any new applicants in 7th or 8th grade. If your student was in Tutoring Chicago programming at any point in 2020-2021 as a 6th or 7th grader, they may apply as a returning student for our middle school program, serving 7th and 8th graders.  












check all that apply





Parent/Guardian Information


First and Last name required



apt/unit #







The following information MUST BE DIFFERENT than parent/guardian.


First and Last name required


School Information


Tutoring Chicago provides services to children in grades 1-8. We do not enroll children in kindergarten or grades 9-12. 

We do not accept any new 7th or 8th grade students. If your student will be a 7th or 8th grader during the 2021-2022 school year, they can only apply and participate in Tutoring Chicago if they were in the program in 2020-2021 as a 6th or 7th grader.  







ex. student has homework in Spanish









Health Information

The following information is confidential and collected for your child’s safety.



This information is confidential

This information will be displayed on your student’s nametag for safety.

This information will be displayed on your student’s nametag for safety.


This information will be displayed on your student’s nametag for safety.


This information will be displayed on your student’s nametag for safety.


During the 2021-2022 school year, Tutoring Chicago will offer in-person and digital tutoring options to students once a week.

  • In-person options are available to: 1st-6th grade students applying for the SMART program. 
  • Digital options are available to all students.
  • Students can not be enrolled in both in-person and digital programming. Parents must choose one method. 
  • Tutoring Chicago may recommend that your student receives tutoring in person even if you prefer digital tutoring.

Tell us more about your student’s needs and preferences. Our staff will do our best to accommodate the preferences of our students but we may not be able to accommodate all preferences due to limited capacity of physical space or volunteer availability.

Tutoring Chicago will be offering in-person tutoring Monday, Tuesday, and Wednesday nights from 6:00-7:30pm for select students at 2 different locations:

St. Vincent dePaul Center – Lincoln Park – 2145 N Halsted St.
Hope Learning Academy  – Near West Side – 1628 W Washington Blvd.

Tutoring Chicago will also continue offering 1:1  digital tutoring via weekly hosted Zoom sessions from 6:00-7:30pm. Tutoring Chicago will do its best to accommodate your preferences,  but will not be able to in all cases. Below we ask you to provide your preferences related to 2021-2022 tutoring:

Program





Days
Each student attends SMART tutoring once a week in the evenings for 90 minutes on Monday, Tuesday OR Wednesday. There will not be an option for independently scheduled tutoring. 

Tutoring will take place between 6:00-7:30pm.

Tutoring Chicago will do its best to accommodate your first and second choices when it comes to tutoring night, but can not guarantee accommodation.


Preference Statements




Technology Access

Online tutoring relies heavily on internet access. The following questions will help Tutoring Chicago determine your student’s needs during an online tutoring session. If your student does not have access to a computer at home, Tutoring Chicago can lend one to your student for the year. Parents must first sign the consent below.





Enter Parent Full Name

Family Financial Information

Tutoring Chicago provides free tutoring services for children from families facing financial barriers. The following information is required to ensure we are following our mission and providing quality services. This information is only accessible to Tutoring Chicago staff and will remain strictly confidential. Please be prepared to provide verifying documentation if requested.











Policies

Read and initial each statement. Write “N/A” if you do not consent. 
Digital and In-Person Permission:
I understand that Tutoring Chicago is offering both in-person and digital tutoring options during the 2021-2022 school year. I understand that Tutoring Chicago will do its best to accommodate my preferences but may not be able to in all cases. I understand that my child will be expected to connect on time either digitally via Zoom or in-person at one of our two locations with their assigned tutor, working on academic enrichment once a week.

I recognize that Tutoring Chicago will provide a schedule, guidance, resources and best practices for these sessions. I understand that it is my responsibility as a parent/guardian to supervise and facilitate any digital contact between my child and their tutor (video-conferencing, emails, facetime, phone-calls, texts, etc). 

General Permission
I give permission for my child to be enrolled in the Tutoring Chicago program. I understand the program is a service to my child and that my child may be dismissed at any time. If my child is to remain enrolled, he or she must attend each session and follow the rules. I understand that attendance is essential to my child’s improvement. I will inform the tutor and a Tutoring Chicago staff member if my child is going to be absent. I recognize that tutoring is a resource not to be taken away as a form of punishment.

Academic Data 
I permit Tutoring Chicago and my child’s tutor to contact my child’s school, teacher(s), counselor(s), administration, and/or school system to attain specific information about my child’s academic performance and needs including, but not limited to, report card grades, standardized test scores, homework scores, academic strengths and weaknesses, social/emotional well-being, and general classroom performance. I understand that this information may be shared with my child’s tutor in order to aid the learning process. I understand that this information will be housed in Tutoring Chicago’s database and viewable by Tutoring Chicago staff and third party consultants for data analysis purposes. 

Medical Emergency 

In the event of a medical emergency, I grant permission for my child to be transferred to a medical facility for treatment and receive the treatment deemed necessary by the qualified medical staff at that site. I will be responsible for all costs incurred with such treatment(s). I understand that in the event of such an emergency, Tutoring Chicago will make all reasonable attempts to contact the parent/guardian or emergency contact I have listed on this application. In consideration of being permitted to participate, I do hereby waive and release Tutoring Chicago and all affiliates, directors, employees and volunteers from any and all claims for injuries, including death, damages, property damage, or loss which may occur on account of participation in the tutoring program, including field trips and special events.


Off-site Contact TUTORING CHICAGO neither encourages nor endorses in-person, off-site independent contact and activities between students and tutors. If such relationships and/or activities are to take place independent of a tutoring session, TUTORING CHICAGO is not responsible for accidents and/or incidents arising from such events.


Media Release I permit Tutoring Chicago to use any photographs or video footage featuring my child or any artwork, writings, or media statements taken or created in connection with the program for any type of publicity or fundraising without requiring further approval. I understand that Tutoring Chicago may publicize my child’s first name and grade, but will not include their last name or any other identifying information without parent/guardian advanced approval.


Privacy Tutoring Chicago’s privacy policy can be viewed here. I permit and understand the following privacy policies as it relates to information I submitted in this application:

  • Tutoring Chicago will share necessary information with my child’s tutor including; name, age, grade, gender, parent/guardian phone and email as well as any information contained on the school information page of this application.
  • Tutoring Chicago will print my child’s allergies and/or asthma condition on his/her/their nightly name tag for my child’s health and safety. Any additional information I shared about my child’s health may be shared in confidence with my child’s tutor but will not be displayed on a name tag.
  • All other information contained within this application is considered confidential and will only be accessible to Tutoring Chicago staff.



Type full first name


Tutoring Chicago

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