VITAL Tutor Request Form (for parents and teachers)

This form is for the parents of tutees to apply to the VITAL Tutoring program. Please fill out each field so we can accurately match your student with an appropriate Lawrence Tutor.
Lawrence students wishing to be a tutor, please complete the VITAL Tutor Application Form.

Student's Last Name:
Student's First Name:
Guardian's Name:
Home Phone Number:
Other Phone Number:
Email Address:

Student's Grade Level:
Tutoring Subject:
Current School:
Special Requests:
Today's Date:

Thank you! The VITAL Tutoring Program coordinator will contact you soon.

If you have any questions, please contact the VCSC VITAL Coordinator. volunteer.center@lawrence.edu
920.832.6644