Family Enrollment Form

Fall 2026 Tutoring Sessions

**Now Starting 9/8/26: ESE 698 with Dr. Amanda Yurick (Online)

ESE 698 serves learners in grades K-12 by pairing learners with tutors in special education with an emphasis on literacy and math intervention. This course will meet on Zoom on Tuesdays from 6:00-6:45 and 7:00-7:45 (Families may register learners for only ONE time slot. Siblings or additional learners may also register for ONE time slot). Tutors will complete a comprehensive intake evaluation and will work with learners on IEP goals related to literacy and math. Please note the starting date of 9/1/2026 and ending date of 12/8/2026. A Parent/guardian must be available to meet with the CSU tutor on the first and last sessions. Please plan to ensure that learners attend every session and notify the center in advance of absence.

Starting 9/8/26: ESE 421/521 with Dr. Amanda Yurick (Online)

This Assessment and Tutoring Course (ESE 421/521) serves learners in grades K-12 by pairing with assessors in literacy, science, and social studies. This course will meet synchronously on Zoom on Tuesdays from 6:00-6:45 or 7:00-7:45 (families may only be enrolled in ONE time slot per term; families may enroll multiple siblings). CSU student assessors will engage in instructional assessments as well as provide one-on-one academic coaching and support for learners. Learners and their families should bring homework or IEP goals for the CSU student to work on together. Please note the starting date of 9/8/2026 and ending date of 12/8/2026. A parent/guardian must be available to meet with the CSU student during the first and last session. Please plan to ensure that your learner attends every session and notify the center in advance of absence.

 

 

  • Current Start
  • Page 2
  • Page 3
  • Page 4
  • Complete

Course Selection:

Starts 9/8 and focuses on goals related to literacy and math.
Starts 9/8 and focuses on goals related to literacy and math.
Starts on 9/8 and focuses on goals related to literacy, science, and social studies.
Starts on 9/8 and focuses on goals related to literacy, science, and social studies.

Student information (please enroll only one student at a time. Complete additional form for each additional child enrolled):

Student Name/Grade/School Name:

2. Student Gender:

3. Grade

5. Medium of Regular School Instruction

6. Disability Status

7. Preferred Method of Contact/Permission

Parent/Guardian Contact Info (Primary)

Please enter your phone number in the designated format with numbers and dashes (e.g. 555-555-5555)

11. Cell Phone Provider (Primary)

Parent/Guardian Contact Info (Secondary)

15. Cell Phone Provider (Secondary)

Student contact info (Usable by Student)

19. Devices Available for Use (Select all that Apply)

20. Programs/Applications Used/Approved for Student use During Tutoring

Contact Information

Mailing Address
Cleveland State University
2121 Euclid Avenue, JH 130
Cleveland, OH 44115

Campus Location
2485 Euclid Avenue
Julka Hall, Room 130
Cleveland, OH 44115

Contact Us
Phone: 216.687.4768
communitylearningctr@csuohio.edu