logo                  Auburn University 2017 Summer Reading Tutoring

Mondays and Wednesdays June 7 - July 17, 2017

 

Child's name: ________________________________________________________________________

Age: ________  Date of birth: ______________________________________    Sex:    Male    Female

Parents or caretakers: _________________________________________________________________

Address: _________________________________________ E-mail: ____________________________

City: ___________________________    State: _____________________  Zip: ___________________

Telephone     Home: __________________  Work: _________________    Cell: __________________

Emergency contact: ___________________________________________________________________

Telephone: _____________________________ Relation: _____________________________________

School and teacher 2016-2017: __________________________________________________________

Grade 2016-2017: _____ Promoted?  Yes  No 

Is the child dual-enrolled in the Early Childhood Summer Enrichment Program?  Yes  No

Any special conditions (medical conditions, handicaps, allergies)?    Yes    No   If yes, describe:

_____________________________________________________________________________________

Does child have trouble seeing?  Yes   No    If yes, does child wear corrective lenses?    Yes    No

Does child have trouble hearing?    Yes    No          If yes, does child use a hearing aid?    Yes    No

Does child enjoy reading? _____________________________________________________________

Problems with reading you have noticed: ________________________________________________

_____________________________________________________________________________________

Topics child might like to read or write about: ____________________________________________

_____________________________________________________________________________________

Tutoring will take place in 45-minute sessions between 8:00 and 8:45 Monday and Wednesday mornings. We will arrange parking in the Stadium Parking Deck for the duration of the program. Parents will deliver children in the Summer Reading Program by foot or shuttle bus to the west entrance to Haley Center on Duncan Drive by 8:00 AM and meet them there at 8:45 AM. Tutoring will take place in 2423 HC.

Driver(s) who will deliver and pick up my child for tutoring: ______________________________

Car make and license: _________________________________________________________________

Person to contact if child has no ride: __________________________ Phone: __________________

Please complete both pages of this form.


 

Please mark class days on the calendar your child could attend tutoring this summer. (Priority will be given to children who can attend the entire 12-session program and those who have just completed kindergarten or first grade.)

June 2017                                 Summer Reading Tutoring Calendar

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

4

5

6

7 First tutoring (pretests)

8

9

10

11

12 Tutoring

13

14 Tutoring

15

16

17

18

19 Tutoring

20

21 Tutoring

22

23

24

25

26 Tutoring

27

28 Tutoring

29

30

 

 

 

 

 

 

 

 

July 2017

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

2

3 Tutoring

4

5 Tutoring

6

7

8

9

10 Tutoring

11

12 Tutoring

13

14

15

16

17 Last tutoring (posttests)

18

19

20

21

22

 

Hold Harmless Agreement (required)

I, the undersigned parent/legal guardian of _________________________________, acknowledge that accidental injury can result from participation in the Auburn University Summer Tutoring activities. I, therefore, assume all risk, loss, or damage of property arising out of the participation in this program. I release Auburn University, its Board of Trustees, faculty, students, and staff from all liabilities from any right of action that may accrue either to my child or myself, heirs or representatives, for any such injuries, errors or omissions that I or my child may suffer while participating in this program.

 

________________________________________________     _______________________________

Signature of parent/guardian                                                        Date

I give my permission for a tutor or supervisor in Summer Reading Tutoring to videotape my child to create an instructional video for the Reading Education program at Auburn University.  I understand that all instruction for this video will be typical classroom work using a technique designed to help students improve their reading.

 

________________________________________________     _______________________________

Signature of parent/guardian                                                        Date

 

If you wish to enroll more than one child, or if you have a friend who is interested in our program, please copy this form and return one form for each child you wish to register. You will be notified about acceptance by May 31. If your child is accepted, the fee for the entire program is $80.00, payable at that time, and includes parking in the Stadium Parking Deck during the program. Checks should be made payable to Auburn University. Applications may be e-mailed as attachments (Word or PDF) to murraba@auburn.edu or mailed to:

Dr. Bruce Murray, Summer Reading Tutoring

5040 Haley Center, Auburn AL 36849

 

For links and lessons about learning to read and pictures from Summer Reading Tutoring, visit the Reading Genie website: http://www.auburn.edu/rdggenie