Read On! Partnership Application

School Site

Please list school site and address

Primary Contact Name

First Name

Last Name

Telephone

What school year are you interested in?

Student Population

Describe your student population (i.e. grade levels, number of students, ELA scores, ELLs, socioeconomically disadvantaged, etc.)

Scheduling

Please indicate if your school site will allow tutoring during, after school, or both.

Yes, tutoring can occur both during and after school

No, tutoring can can only occur after school

Space/Room

Please indicate if your school site can provide a dedicate space/room for Read On! tutoring.

Yes

Funding Source(s)

Briefly describe the funding your school site has to subsidize the program.

District/School Requirements

What, if any, requirements will your district/ school have for 916 Ink regarding contracting, 916 Ink employee clearance, or site use?