Literacy Tutoring & Mentoring
Volunteer Registration Form | Nov. 2023 - June 2024
Today's Date
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Month
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Day
Year
Date
Name
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First Name
Last Name
Birthdate
*
/
Month
/
Day
Year
Date
Age
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Gender
*
Email
*
example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone
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Other Phone
What Spoken Languages do you speak, other than English?
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How did you hear about this In-Person Tutoring / Mentoring Initiative?
I would like to be a :
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Literacy Volunteer
School Liaison
Back-up Volunteer
What High School / College did you attend or are currently attending? (please give most recent)
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What is / was your Field of Study?
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What was / is your Occupation? (students can put temp jobs or N/A)
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Past Experience as a Tutor or Teacher? Y/N (experience is not required)
Church you Attend / Ministry Org. / Volunteer Org. (If any)
Ministry Involvement / Other Volunteer Work (If any)
Are you able to Volunteer during school lunch hrs.(typically from 10am-1pm)?
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Yes
No
Are you able to Volunteer during after school hrs.(typically from 2:30pm-5pm)?
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Yes
No
What days are you available? (Please select all that apply)
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Monday
Tuesday
Wednesday
Thursday
Friday
How many children would you be able to help at one time? (5 children is maximum)
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1 child
2 children
3 children
3-5 small group of children
If needed, would you stay for additional periods of the day and help more children? (For ex: 1 pd is 45 min., 2 pds are 90 min., 3 pds are 2hrs:15min.)
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Yes, 2pds
Yes, 3pds
Only 1 pd
If needed, would you continue to Tutor from Mid May - June for Extra Tutoring for kids who may need the additional help?
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Yes
No
If it was required for schools to return to remote learning at any point, would you continue as a Virtual Tutor?
Yes
No
Kindly advise if you have a school preference. (Preferences are not guaranteed)
What Questions, Comments or Concerns do you have? (if any)
Will you comply with a Background/Fingerprinting check?
*
Background Check & Fingerprinting Instructions with Identigo are sent to your Email. If you have registered with Identigo before, you do not need to do it again. (There is no cost to you for fingerprinting)
Literacy Tutors & Mentors are expected to be Faithful in their Commitment to help the Children on their assigned days & times, on a weekly basis, for the Length of the Program.
Thank you for Signing up to Be a Literacy Tutor & Mentor.
Blessings!
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