TEEN HOMEWORK HELP PROGRAM – LEARNER APPLICATION FORM
Application Deadline – Friday, January 30th, 2015
Frontier College is a national, non-profit literacy organization founded in 1899.
We work together with children, youth, adults and families to improve their
literacy skills. Across Canada, our community-based programs are volunteer-run, offered in partnership with
community organizations.
This program is offered in partnership with the Saskatoon Public Library. It runs from mid-October to early
December, and from late January or early February (for new matches) to early April. A volunteer tutor is paired
with each learner to work together, one-to-one, for 1.5 hours per week at a set time at one of the participating
Library branches. Learners can be ages 12-18 in grades 6-12. For locations, days and times, visit
www.frontiercollege.ca/english/literacy/saskatoon.html or contact us (contact information on last page).
Date: __________
City: _______________________
Program Location: ________________
A. Information on Your Child – this may be shared with your child’s tutor
Child’s First Name: _______________________
Age: ________
Gender:  Male
School Attended: _______________________
Child’s Last Name: _______________________________
 Female
Other
Grade: ______ Language Spoken at Home: ______________
Goals: what do you want your child to work on in the program?
1.
2.
3.
What does your child like to do at school?
In which school subjects does your child want homework help (what do they want to do better)?
What activities does your child like to do (examples: sports, music, art)?
What extracurricular activities is your child enrolled in (examples: hockey, dance)?
TEEN HOMEWORK HELP PROGRAM – LEARNER APPLICATION FORM
Application Deadline – Friday, January 30th, 2015
What other resources have you tried for homework help, tutoring, or academic support for your child?
How did you hear about Frontier College? ________________________________
How many years has your child attended the Teen Homework Help Program? _____ years.
 Yes  No
Has your child gone to other Frontier College programs?
Year: _______________________
If yes, please complete
Location: ________________________________
Why would you like to seek a volunteer tutor from Frontier College to work with your child on his/her
homework?
B. General Information – this will be kept confidential
Contact Information (in case of emergency):
Your Name: _______________________________
Your Phone Number: ___________________
Alternate Phone Number: _________________
Your Email Address: ____________________________________________________
Your Home Address (include your postal code):
_____________________________________________________________________________
Alternate Contact:
Name: ____________________________________
Phone Number: _________________
Are there any health concerns, medications, or allergies that Frontier College should know about?
______________________________________________________________________________
What grades (marks) did your child get on their report card in June 2014? (This will help Frontier College to
measure how our programs help students.)
Reading ________________
Writing _________________
Math ___________________
TEEN HOMEWORK HELP PROGRAM – LEARNER APPLICATION FORM
Application Deadline – Friday, January 30th, 2015
Parental Permission
1. I agree that Frontier College can write down how my child is doing at school and ask my child about the
program. I understand that all information will be kept private.
 Yes  No
2. I agree that Frontier College can take photos of my child and collect samples of their work. I understand
that these photos may be printed in newspapers, web sites, reports, etc.
 Yes  No
 Yes  No
3. I agree that Frontier College can contact my child’s teacher.
a. If yes, what are the teachers’ names for the subjects you’d like homework help?
_________________________________________________________________________
4. Departure from the program (for after-school and programs on weekends only)
( ) I ALLOW my child to leave for home at the end of the tutoring session by himself/herself. I agree
that Frontier College will not be held responsible for any incidents that may occur once the child leaves
for home at the end of the session.
( ) I DO NOT ALLOW my child to leave the program site on his/her own. I agree that it is my
responsibility to ensure that he/she is picked up at the end of the session by myself or the alternate
contact. If another person is picking my child up, I will notify Frontier College.
I understand that this is an application that will be considered, along with all other Teen Homework Help
Program applications, after the application deadline (Friday, January 30th, 2015). Completing and submitting
this form is not a guarantee of a match with a volunteer tutor, as Frontier College often has more requests
for help than they have volunteers. However, if no match is made, Frontier College will keep my application on
file in case volunteer tutors become available.
I also understand that Frontier College’s resources are limited and confirm in all good faith that I can justify my
child’s requirement for a tutor, even if that means another child may not get a tutor.
_______________________________________________
__________________________
Signature
Date
Thank you for your application to the Teen Homework Help Program! You can submit your form by mail or
drop it off at the address below. If you have any questions, please contact us at (306) 374-7323 or
saskatoon@frontiercollege.ca
Frontier College Saskatoon
315 Avenue M South
Saskatoon SK, S7M 2K5