Registration

Apply to become a scholar-tutor, or register a student for tutoring, workshops, and enrichment.

Student & Family Registration Form

Thank you for your interest in our Summer Academic Enrichment Program!

Our program is designed to strengthen students’ reading and mathematics skills, build academic confidence, prevent summer learning loss, and prepare students for success in the upcoming school year.

Please complete one registration form for each student you wish to enroll.

Section 1: Student Information

Student's Full Name *

Student's Date of Birth *

Current Grade Level (2025–2026 School Year) *

School Student Currently Attends

School District *

Section 2: Parent/Guardian Information

Parent/Guardian Name *

Relationship to Student *

Email Address *

Primary Phone Number *

Secondary Phone Number

Home Address *

Preferred Method of Communication * (select all that apply)

Email Phone Call Text Message

Section 3: Tutoring Registration

Which subject(s) would you like your child to receive tutoring in? *

Reading Mathematics Reading & Mathematics

Section 4: Reading Skills

Which reading skills would you like your child to strengthen?

Reading Fluency Reading Comprehension Vocabulary Development Phonics Context Clues Main Idea & Supporting Details Making Inferences Summarizing Identifying Theme Author’s Purpose Character Analysis Compare & Contrast Cause & Effect Using Text Evidence Informational Text Analysis Grammar Sentence Structure Written Responses Essay Writing Reading Confidence Unsure

How would you describe your child’s current reading performance?

Below Grade Level Slightly Below Grade Level At Grade Level Above Grade Level Unsure

Section 5: Mathematics Skills

Which math skills would you like your child to strengthen?

Addition & Subtraction Multiplication & Division Fractions Decimals Percentages Word Problems Measurement Geometry Ratios & Proportions Integers Expressions & Equations Pre-Algebra Algebra I Algebra II Functions Probability & Statistics Problem Solving Strategies Math Confidence Unsure

How would you describe your child’s current math performance?

Below Grade Level Slightly Below Grade Level At Grade Level Above Grade Level Unsure

Section 6: Student Learning Profile

Has your child previously received tutoring or academic intervention?

Yes No

Does your child currently receive any of the following educational services?

Individualized Education Program (IEP) Section 504 Plan English Learner (ELL/ESOL) Gifted & Talented Program None Prefer Not to Answer

Please share any additional information that would help us support your child’s learning.

Examples: learning style, accommodations, attention needs, interests, or motivational strategies.

Section 7: Parent Goals

What are your goals for your child’s participation in this program?

Prevent Summer Learning Loss Improve Reading Skills Improve Math Skills Increase Academic Confidence Prepare for the Next School Year Strengthen Study Skills Improve Homework Habits Improve Test-Taking Skills Receive Individualized Academic Support Other (Please Specify)

Please describe any specific academic concerns or skills you would like the tutor to focus on.

Section 8: Program Schedule

Which days will your child attend?

Monday Tuesday Wednesday Thursday Friday Full Week

Program Hours 3:00 PM – 6:00 PM

Program Location Howard County Library System – Central Branch

Section 9: Emergency Contact

Emergency Contact Name *

Relationship to Student *

Emergency Contact Phone Number *

Section 10: Media Release

Do you give permission for your child to be photographed or recorded during program activities for educational and promotional purposes? *

Yes No

Section 11: Parent/Guardian Agreement

By submitting this registration, I certify that the information provided is accurate. I understand that regular attendance is essential for my child’s success and agree to ensure my child arrives on time and participates respectfully throughout the program. I understand that enrollment is subject to availability and that every effort will be made to match my child with a tutor who best meets their academic needs.

Payment Information:
Registration will not be finalized until payment is received. As of July 2026 payment must be mailed to the Talented Ten physical address:
Talented Ten Tutoring
5457 Twin Knolls Rd
Ste 300 #1531
Columbia, MD 21045
*Electronic payments will be offered in the near future

Parent/Guardian Electronic Signature *

Date *

Optional Student Matching Questions

These questions help us pair your child with the tutor who is the best academic and personality fit.

What does your child enjoy most about school?

What motivates your child to learn?

What are your child’s hobbies or interests?

How does your child learn best? (select all that apply)

Visual Learner Hands-On Learner Listening/Discussion Reading & Writing Small Group Instruction One-on-One Instruction Not Sure

Tutor Application

Thank you for your interest in becoming a tutor with our Summer Academic Enrichment Program!

We are seeking academically strong high school and college students who are passionate about helping students in grades 3–9 strengthen their reading and math skills while serving as positive mentors and role models.

Section 1: Personal Information

Full Name *

Date of Birth *

Email Address *

Phone Number *

Home Address *

Current Status *

High School Student College Student

School Name *

Current Grade Level / College Year *

Current GPA *

Expected Graduation Year *

Section 2: Academic Background

Academic Honors and Achievements (select all that apply)

Honor Roll Principal’s Honor Roll National Honor Society National Junior Honor Society AP Courses IB Courses Dual Enrollment Gifted & Talented Program Dean’s List Academic Scholarship Recipient Other (Please Specify)

Subjects in Which You Excel (select all that apply)

Mathematics Reading/English Language Arts Science Writing Social Studies Foreign Language Other

Section 3: Mathematics Tutoring Strengths

Which math topics do you feel confident tutoring? (select all that apply)

Elementary Mathematics

Number Sense Place Value Addition & Subtraction Multiplication & Division Fractions Decimals Percentages Word Problems Measurement Geometry Data & Graphing

Middle School Mathematics

Ratios & Proportions Integers Expressions & Equations Functions Probability & Statistics Geometry Pre-Algebra Algebra I Problem Solving Strategies

High School Mathematics

Algebra I Algebra II Geometry Trigonometry Pre-Calculus Calculus Statistics

Overall Confidence Teaching Mathematics *

Beginner Proficient Advanced Expert

Section 4: Reading & English Language Arts Strengths

Which reading and language arts skills do you feel confident tutoring? (select all that apply)

Reading Fluency Reading Comprehension Vocabulary Development Phonics Context Clues Main Idea & Supporting Details Making Inferences Summarizing Identifying Theme Author’s Purpose Character Analysis Compare & Contrast Cause & Effect Using Text Evidence Literary Elements Informational Text Analysis Grammar Sentence Structure Essay Writing Editing & Proofreading

Overall Confidence Teaching Reading/ELA *

Beginner Proficient Advanced Expert

Section 5: Experience Working with Students

Have you previously worked with children? *

Yes No

If yes, please describe your experience.

Have you ever tutored or taught before? *

Yes No

If yes, please describe your tutoring or teaching experience.

Please select any experiences you have had working with youth. (select all that apply)

Peer Tutor Mentor Babysitter Summer Camp Counselor Coach Sunday School Teacher/Volunteer After-School Program Community Service with Children Youth Organization Volunteer Other (Please Specify)

Section 6: Mentoring & Communication

Why are you interested in becoming a tutor? *

Describe a time when you helped someone understand something they were struggling to learn. *

A student says, “I’m just not good at math.” How would you respond? *

Which qualities best describe you? (select all that apply)

Patient Responsible Dependable Positive Respectful Organized Encouraging Creative Flexible Good Listener Strong Communicator Professional

Section 7: Availability

Which days are you available? (select all that apply)

Monday Tuesday Wednesday Thursday Friday

Are you available to work from 3:00 PM–6:00 PM? *

Yes No

Do you have reliable transportation to your assigned tutoring location? *

Yes No

Section 8: Short Answer Questions

What do you hope students remember most about you after working with you? *

What accomplishment are you most proud of, and why? *

Is there anything else you would like us to know?

Section 9: References

Reference #1

Name *

Relationship *

Phone Number *

Email Address *

Reference #2

Name

Relationship

Phone Number

Email Address

Parent/Guardian Information

Because your date of birth indicates you are under 18, a parent or guardian must provide their contact information and sign this application on your behalf.

Parent/Guardian Full Name *

Parent/Guardian Phone *

Parent/Guardian Email *

Section 10: Applicant Certification

I certify that all information provided in this application is true and complete to the best of my knowledge. I understand that any misrepresentation or omission may result in disqualification from consideration or dismissal from the program.

Electronic Signature *

Date *