Home Directions Key Contacts Directors Message / Annual  Appeal Newsletter Programs Registration Application

Tutor Application

Tutors Name
First: Last: (M. I.):
Sex:
First: Last:

Home Address
Address:
      City: State: Zip code: -
  E-Mail: 

Home Telephone #   ( ) -
Work Telephone #   ( ) -

_______________________________________________________________________
College Tutors

Major: Year:

Adult Tutors
Employer: Title/Occupation:

High School Tutors

School:
Grade: Counselor/Adviser:
Preferred Subjects 
1st Choice:  Any Grade    or    Grades -
2nd Choice:  Any Grade    or    Grades -
3rd Choice:  Any Grade    or    Grades -
4th Choice:  Any Grade    or    Grades -

Have you tutored before?     If Yes, which grade?
Prefer male or female?
Major Hobbies, interests, etc:
_______________________________________________________________________
Availability
Please select all the availble times. Tutoring runs from 4:00 p.m. - 8:00 p.m. weekdays
and 9:30 a.m. - 12:30 p.m. Saturdays

Monday:  to
Tuesday:    to
Wednesday:    to
Thursday:    to
Saturday:    to

How many students would you like to tutor (1,2, small group)?

Additional Comments:

_______________________________________________________________________
Please List Two References
Name: Address: Phone: ( ) -
Name: Address: Phone: ( ) -

      
Webeyezed.com
Webeyezed.com