Please fill out this application if you would like to enroll your child in our tutoring and STEM program.Tutoring Application If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Child's Name * Sex * MaleFemale Child's Date of Birth * Number of Siblings Racial Background Religion Primary Language * Address * Home Phone * Email * Guardian’s Name Guardian’s Phone Guardian’s Occupation Guardian's Days and Hours Worked Emergency Contact Name * Emergency Contact Phone * Emergency Contact Address * Emergency Contact Relationship * Name of your School * Grade Level * Reading Level * School Address and Phone * How did you hear about the IN ARMS REACH Tutoring Program? Describe the academic difficulties that the child is having in school What subject does the child seem to enjoy the most? What are the most challenged academic subjects she/he may need tutoring assistance with? ReadingMathSocial StudiesEnglishScienceWriting Have you ever applied to this program or any other tutoring services? YesNo Please list anyone living at home or a relative or friend invited to the home that can assist child with his/her homework If yes, where and when? Please list any civic groups, clubs, religious activities, mentoring organizations or community service projects of which the child is a member Children of Incarcerated Parents and Impacted by the Justice System are given priority for enrollment in the program. Name of incarcerated parent or individual, First and Last Name * Gender MaleFemale Prison Identification number? Relationship?