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Online Tutoring Application

Tutoring Online Application

PARTICIPANT’S INFORMATION


PARENT/GUARDIAN INFORMATION


TUTORING SITE

Please choose your preferred Site & Day for tutoring.


LIABILITY RELEASE / KUBONA INSHINGANO

You must agree to the following terms and conditions by clicking the check box.


PHOTO RELEASE / FOTO YASOHOTSE

You must agree to the following terms  and conditions by clicking the check box.


STUDENT BEHAVIOR CONTRACT / AMASEZERANO Y'ABANYESHURI

You must agree to the following terms  and conditions by clicking the check box.


Sorry, but we are no longer accepting applications at this time.
Tutoring Online Application

PARTICIPANT’S INFORMATION


PARENT/GUARDIAN INFORMATION


TUTORING SITE

Please choose your preferred Site & Day for tutoring.


LIABILITY RELEASE / KUBONA INSHINGANO

You must agree to the following terms and conditions by clicking the check box.


PHOTO RELEASE / FOTO YASOHOTSE

You must agree to the following terms  and conditions by clicking the check box.


STUDENT BEHAVIOR CONTRACT / AMASEZERANO Y'ABANYESHURI

You must agree to the following terms  and conditions by clicking the check box.


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Registration Form Must Be Completed by a Parent or Guardian.

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Email it to [email protected].

You May Also Mail it to:
Positive Impact for Life
6026 Kalamazoo Avenue SE #110
Grand Rapids, MI 49508
Attn: Tutoring