SLC Tutor Application Form

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail Address*

Phone Number*

Area CodePhone Number

Male/Female

MaleFemale

Birth Date

MonthDayYear

How did you hear about us?

When can you start working for us

What skills do you bring to Success Learning Center?

Please enter the age groups you are able to tutor.

Hold CTRL for multiple selections

If you have tutored before, tell us about it here.

Please list the subjects and levels you can teach, these are those you would be expected to teach.

Subject No 1

Subject No 2

Subject No 3

Subject No 4

Subject No 5

Subject No 6

Subject No 7

Subject No 8

Do you have a Diploma?

YesNo

College/University Name

Do you have a Degree?

YesNo

List Degree Type/Major

List State and Certification Number

Do you hold Teacher Certification?

YesNo

Which Areas/Subjects?

Are you working towards a Teaching Certification?

YesNo

Please list which Subject/Area/Grade Level

Do you have any other qualifications?

Do you agree to have a background check?

YesNo

Confirm you are eligible to work in the US

YesNo

Do you have a criminal prosecution pending?

YesNo

If yes please tell us about it here.

Do you have a valid state driver's license?

YesNo

Which days are you able to tutor?

Hold CTRL for multiple selections

Which times are you available.

Hold CTRL for multiple selections

Are you currently employed?

YesNo

Are you currently a full-time college student?

YesNo

Please tell us of any special skills you may have.

Have you worked with children with learning and/or developmental disabilities?

YesNo

Please tell us more

Please tell us a little more about yourself, what motivates you, your passions and future goals.

Do you have experience working with students with emotional disorders (Depression, Anxiety, ADHD)?

YesNo

Please tell us more

We aim to provide a great match between the tutor and the student. This enhances the learning experience and adds real value to the student and the tutor. To help us make this match give us some idea of your interests, hobbies etc.

Please provide the names of two professionals we can use as references. (These cannot be family or friends)

First reference

Name

Telephone

Email

Profession/Relationship

Second reference

Name

Telephone

Email

Profession/Relationship

Browse you computer or network to upload your CV/Resume

Upload your CV/Resume

Upload a File

Browse you computer or network to upload your Profile Picture

Upload your Picture

Upload a File

Optional