Request for a Tutor « CASA Support Council for Pima County, Inc.

Request for a Tutor

CASA SUPPORT COUNCIL FOR PIMA COUNTY, INC.

Please note that all items marked with an * must be filled out before you can submit the form. You will receive a confirmation email that your form has been received & we will contact you soon. If you have any questions on filling out the form, please contact Katie Hamlin at [email protected].

* Click Submit below when finished with the form.

CASA's Name*

(Last, First, Middle)
CASA's Email (do not use a personal email)*
Date of Request*
MM slash DD slash YYYY
CASA's Phone #*
Child's Legal Name*
Child's Age & Grade*
Name of School & School District*
Primary Teacher's Name*
Teacher's email*
Tutor Gender Preference?*
- No Preference
- Female
- Male
Subject(s) to be Tutored*
Days of the Week Child is Available*
What time frames is the child available?*
Does the child have an IEP?*
- Yes
- No
Does the child have a 504 plan?*
- Yes
- No
Does the child have a language barrier?*
- Yes
- No
Placement's Name*
Placement's Email*
Placement's Phone#*
Placement's Address*
Additional Notes That May Be Helpful
Name
This field is for validation purposes and should be left unchanged.

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Request for a Tutor

CASA SUPPORT COUNCIL FOR PIMA COUNTY, INC.