Registration for Reading/Math Buddies -- 2013-2014

Children enrolled in grades 1-5 for the 2013-2014 school year can sign up to be paired with a Teen Buddy to work on reading or math skills.
The Library will assign partners, and the parent and teen volunteer will set a mutually agreeable schedule. We recommend weekly one-hour meetings.
Meetings must take place inside The Library.
This program runs for 20 consecutive weeks, beginning with the date that you are notified of your child's acceptance. Students are limited to completing one 20-week session within a 12-month period unless there is no waiting list.
Completing this form does not guarantee immediate placement in the program. You will be notified when we have a spot for your child.
Kid Buddies will be assigned to Teen Buddies on a first come, first served basis, as the availability of Teen Buddies permits and with priority enrollment granted to struggling students who are referred to the program by their schools.
Questions? Please call the Youth Services Department at The Library at (732) 390-6789.

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* 1. Child's First Name:

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* 2. Child's Last Name:

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* 3. Check one:

Girl

Boy

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* 4. Kid Buddies must be entering 1st through 5th grades in September 2013. Homeschoolers must be of an equivalent age.

Please indicate your child's grade level for the 2013-2014 school year:

1st grade

2nd grade

3rd grade

4th grade

5th grade

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* 5. Which school is your child attending for the 2013-2014 school year?

Bowne-Munro

Central

Chittick

Cornerstone Christian School

Frost

Hatikvah

Irwin

Lawrence Brook

Memorial

RPRY

Solomon Schechter

St. Bartholomew

Warnsdorfer

Yeshiva Shaarei Tzion

Other (please specify)

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* 6. Parent's First Name:

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* 7. Parent's Last Name:

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* 8. Family's Street Address:

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* 9. Town and Zip Code (for mailing purposes):

Please note: Any phone numbers or e-mail addresses you provide will be shared with your child's Teen Buddy for the purpose of contacting you.

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* 10. Parent's Phone Number:

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* 11. Parent's E-mail Address:

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* 12. Parent's or Child's Library Card Barcode:

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* 13. What is the best way for your child's Teen Buddy to contact you?

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* 14. You may register your child for help with either reading or math, not both.
Please do not fill out this form twice for the same child.
For which subject are you registering your child?

Math

Reading

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* 1. Child's First Name:

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* 2. Child's Last Name:

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* 3. Check one:

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* 4. Kid Buddies must be entering 1st through 5th grades in September 2013. Homeschoolers must be of an equivalent age.Please indicate your child's grade level for the 2013-2014 school year:

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* 5. Which school is your child attending for the 2013-2014 school year?

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* 6. Parent's First Name:

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* 7. Parent's Last Name:

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* 8. Family's Street Address:

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* 9. Town and Zip Code (for mailing purposes):

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* 10. Parent's Phone Number:

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* 11. Parent's E-mail Address:

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* 12. Parent's or Child's Library Card Barcode:

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* 13. What is the best way for your child's Teen Buddy to contact you?

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* 14. You may register your child for help with either reading or math, not both.Please do not fill out this form twice for the same child.For which subject are you registering your child?

* 4. Kid Buddies must be entering 1st through 5th grades in September 2013. Homeschoolers must be of an equivalent age.

Please indicate your child's grade level for the 2013-2014 school year:

* 14. You may register your child for help with either reading or math, not both.
Please do not fill out this form twice for the same child.
For which subject are you registering your child?