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Request for after school tutoring through MI Kids Back-on-Track. EUE or EJSHS
Parent, legal guardian and student request form
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* Indicates required question
Student Last Name
*
Your answer
Student First Name
*
Your answer
Parent / Guardian Last Name
*
Your answer
Parent / Guardian First Name
*
Your answer
Parent / Guardian Phone Number
*
Your answer
Student School of attendance
*
Escanaba Upper Elementary
Escanaba Junior Senior High School
Student Grade Level
*
Your answer
Area of need
*
Math
English Language Arts (Reading and Writing)
Transportation Needed
*
Yes
No
If answered yes to transportation, please include address for drop off or pick up (summer school only)
Your answer
Any other information the school may need to know?
Your answer
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