WISE Tutor Application

TUTOR APPLICATION
Applicant name*

First NameLast Name
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Are you currently affiliated with a tutoring organization?*

Yes, I am affiliated with an organizationNo, I operate independently
If yes, please provide the name of the organization:
What STEM area(s) are you able to tutor in?
How many hours can you commit to tutoring per month?

1-2 hours3-4 hours5-7 hours
Why do you believe you would be a strong tutor?*
Please provide any other information you believe would be important in review of this application.
Are you willing to undergo a background check as part of this hiring process?

YesNo
Declaration by Tutor

This application has been made by me after having read and understood all the rules of the program.

I declare that the information furnished by me in this application is true to the best of my knowledge and belief.

I agree to observe the rules relating to WISE.

By pressing the Submit Button, I confirm the above declaration and accept the terms and conditions.
Acceptance of Terms & Conditions and Declaration of Tutor
Signature*

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TUTOR APPLICATION