Easy Sign Up
When you are ready to sign up, simply print this page, fill it out and bring with you when you set up a time to meet with Mrs. Glenn. Your first visit will be a get acquainted session and time to set up a schedule.
Student Name:___________________________Age:________Grade:___________
Parent Name:______________________________________________
Address:___________________________City______________State____________Zip__________
Phone Numbers:________________________________
Is this application for ____Home School Assist or ____Student Assist (public school attendee)
Area of interest for assist (circle all that apply): math reading writing language arts
foreign language (specify___________) science
social studies phonics spelling art
physical education (PE) Biblical Studies
other (specify________________)
__________________________________________________________________________________________________________________________
To be filled in by HLC
Schedule: M T W Th F Time:_________to_______________
Start Date:_____________________
Payment: ______each week ______upon completion of each session
initials_______