NJC Tutoring Survey

Please complete the form below:

Are You A Member Of NJC?	*
If No, Which Church Are You A Member Of?
Title	*
Parent First Name	*
Parent Middle Name
Parent Last Name	*

Cell Number

Child Grade	*
Child First Name	*
Child Middle Name
Child Last Name	*

Subject in Need of Assistance?	*
If tutoring is provided on Wednesday evening, would you be able to attend?	*