45 Bristol Street, New Haven, CT 06511 information@newhavenreads.org 203-752-1923
Volunteer

Waitlist Application 2

Student Information
Date (required):
Student’s Name (required):
Address (required):
Apartment:
City (required):
Zip Code (required):
Date of Birth (required):
Age (required):
Gender (required):
School (required):
Current Grade (required):
Does he/she have any siblings enrolled in the NHR tutoring program? (required)
If yes, please list:
Preferred Day for Tutoring:
Preferred Time:
Has he/she ever been retained? (required)
If yes, what grade?
Have you received notification that he/she will be retained? (required)
Does he/she receive special services at school? (required)
If yes, describe:
Please include any additional information that may affect his/her academic progress:
Do you have a computer at home with internet connection?
What is the primary language spoken at home? (required)

Guardian Contact Information

Primary person student lives with (required):
Relationship to student (required):
Home Phone:
Cell Phone (required):
Email Address (required):

Parent Acknowledgements

I understand:

  • The New Haven Reads (NHR) program is for children who are struggling with reading.
  • My child will be added to the Waitlist on the date I submit a completed waitlist application form.
  • I am responsible for making sure that my phone numbers are current.
  • NHR fills openings based on the date a child is entered on the Waitlist. When space becomes available for my child, NHR will attempt to contact me using the phone numbers I have provided.
  • If I do not respond within the time frame indicated in the message, the space will be offered to another child.
  • After three unsuccessful attempts to offer my child placement in the program, NHR will remove my child from the Waitlist.
  • I can find other resources for my child at https://newhavenreads.org/resources/literacy-resources.
Parent/Guardian Signature (required):
Date (required):
Book Bank Hours

45 Bristol Street
New Haven, CT 06511

203-752-1923

(EIN) 760807330

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Our Mission

New Haven Reads increases the literacy skills of children by providing individually tailored one-on-one after school tutoring, educational family support, and a community book bank, all at no cost to participants.

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