16-17 Educators Rising (FEA) Sign-Up
By filling out and submitting this form, you are acknowledging that you have read and are agreeing to uphold the 2016-2017 tutoring contract.  You understand that you owe a $15 membership/dues fee, and that it must be turned in before you will receive a tutoring placement, and that if all tutoring slots are filled, you will be placed on a wait list in the order in which your form AND fee are received.
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First Name *
Last Name *
Email Address *
Class *
Street Address *
City *
Zip Code *
Birth Date *
MM
/
DD
/
YYYY
Adult t-shirt size *
School assignment - FIRST Choice *
School assignment - SECOND Choice *
Desired Grade Level *
If you would be interested in tutoring in a specific subject area that you are experienced in, please list below
(music, art, pe)
TRANSPORTATION *
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