lcs21_Tutor & Volunteer Application

Application for Tutors and Volunteers
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Closest Library
May we e-mail you information, schedules, and other opportunities?*
Date of Birth*

MonthDayYear
Home
(###) ###-####
Cell
(###) ###-####
E-mail*
In what month would you prefer to receive training? Check all you would like.

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
I am interested in (check all that apply)

Basic Literacy Program: Teaching adults to read and write (basic literacy skills)ESOL Program: Teaching English to adult speakers of other languagesVolunteering in another capacity

Preferred times for tutoring: Please check all that apply to assist matching with an adult learner.

Education (grade or college level completed) and any field of study.
Are you a seasonal or a full-time resident of the Sarasota area?
Number of months you spend in Sarasota
How did you hear about the Literacy Council?
Photo Release Statement

I authorize and grant the Literacy Council of Sarasota permission to reproduce and distribute by printed or electronic means my photographic image(s). I understand and agree that the use of such images will be without monetary compensation and may be used by the organization in mass media, displays, brochures, websites, etc. By adding my name below, I show that I have read this statement and understand this release and agree to accept its provisions.
Name

First NameLast Name
Date

MonthDayYear
Volunteer and internship positions available. Check all that apply:

Tutor training – Train and mentor other volunteer tutors.Social Networking Coordinator – Help maintain Facebook and other sites.Speaker’s Bureau – Advocate for literacy through presentations and speaking engagements.Literacy Writer – Write articles, press releases and copy for LCS.Events – Help coordinate, plan or organize events.Other
Should be Empty:

Application for Tutors and Volunteers