Tutor Applicant Information

Tutor Applicant Information
Date *

Month Day Year
Name *

First Name Last Name
Date of Birth *

Month Day Year
Age *
Gender *
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
E-mail *
Job *
Education *
Technical Knowledge *
Basic knowledge of computers.
Do you have available transportation? *
When are you available? *
Are you available during winter? *
Do you have a criminal record? *
This includes misdemeanors and felonies.
Please explain *
Learner Preference *
Second Language
Would you be willing to tutor a student whose second language is English? *
Would you be willing to tutor a student with a felony or other criminal record? *
Would you be willing to tutor a developmentally disabled student? *
Anything else you would like us to know about you?
Please read: We are an alcohol, drug, and weapon-free organization. You are expected to keep all of the appointments made with your client. If you are unable to meet, you must call your client ahead of time and cancel. We reserve the right to deny participation in literacy project services.
I agree to these rules and verify that the information I am submitting is to the best of my knowledge.
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