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Patrick County High School MATH After-School Tutoring Sign-Up Sheet Date:______________________________ Student’s Name:_________________________________________________________ Subject in which to be tutored (please circle): MATH 8 & ALGEBRA I GEOMETRY & ALGEBRA II Classroom Teacher of subject in which to be tutored:_________________________ Time of Tutoring: Tuesday 3:30 – 5:00 (if activity bus is needed, please inform the teacher prior to staying) MATH 8 & ALGEBRA I Room/Teacher: Sept. 13 – Oct. 11 – Algebra Teachers Oct. 18 – End of 1st Semester – Sheila Brown (with Shannon Harrell) GEOMETRY & ALGEBRA II Room/Teacher: Sept. 13 – Oct. 11 - Hope Perry – Room 132 Oct. 18 – End of 1st Semester – Shannon Harrell Room – 184 Transportation: Ride Activity Bus Parent / guardian will pick up at __________ p.m. Student will drive home at ______________ p.m Parent / Guardian’s Signature:________________________________ Phone #____________________ (Signature Mandatory) (which you can be reached during tutoring) Please return this form to the classroom teacher of the subject for which you need help. This allows your child to participate in the tutoring program at PCHS. It is the responsibility of the student to return this completed form to the tutoring instructor on Monday prior to tutoring. This completed form will allow the student to participate in the Math tutoring program on the date specified above.
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