Summer Resource Center Registration

Contract Agreement

By signing and submitting this form, you are agreeing to the terms of our tutoring program as described below.

1. One-on-one tutoring sessions are 45 minutes in length and are designed to meet the specific instructional and academic needs of the individual student.

2. All tutoring sessions will be in person.

3. Tutoring sessions are scheduled by the head of the Resource Center.

4. Two (2) week notice, in advance, is required to terminate the contract. The student account will be adjusted based on the actual number of scheduled sessions.

5. Tutoring reports will be issued at the end of the summer session. Parent conferences are scheduled upon request.

6. Sessions missed due to illness will not be rescheduled. Please notify the head of the Resource Center (kyao@milpitaschristian.org) before 7:30 AM the day of missed session. Earlier notice is preferred.

7. Student accounts will be billed for unexcused absence from a session due to family vacation, medical/dental appointments, detentions, suspensions, or non-MCS related activities or non-emergency conflicts.

*Student First Name

*Student Last Name

*Student Date of Birth

mm-dd-yyyy

*Student is enrolled at MCS

*Student grade level in the upcoming fall

*Mothers First Name

*Mother Last Name

*Mothers Cell Phone

*Mothers Home Phone

*Mothers Email

*Mothers Mailing Address

*Fathers Frist Name

*Fathers Last Name

*Fathers Cell Phone

*Fathers Home Phone

Fathers Email

*Fathers Mailing Address

*How many days a week would you like tutoring?

*When would you like tutoring to occur?

*When is your student NOT available for tutoring?

*List all the summer activities outside of MCS that occur during the weekdays

*Select all that apply: Summer School or Summer Day Camp?

Choice of Week (select all that apply)(hold down shift key for multiple weeks)

*What areas of focus would you like for your student? Check all that apply.

*Is there anything else you would like us to know about your child?

*Does your child have an IEP or 504 PLAN?

*If child does have an IEP or 504 Plan, please provide a copy

List questions, concerns, ideas

*Signature (Full Name)

*Singnature email address

INQUIRE

VISIT

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Milpitas Christian School

Preschool Campus

1000 S. Park Victoria Drive
Milpitas, CA 95035
408.945.6530 x21104

Birchwood Campus

3435 Birchwood Lane
San Jose, CA 95132
408.945.6530

"Equipping followers of Christ

To transform their world."

Copyright © 2023 Milpitas Christian School. All rights reserved._{Milpitas Christian School accepts students of all races and nationalities and does not discriminate in any of its programs based on gender, race, or national origin.

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