TALC Monthly Activities Report

Monthly Activities Report

Thank you for keeping TALC up-to-date. This data will be used to update our records, place you with a new learner, collectively report our progress to ProLiteracy, and for grant writing.
Your Name

First NameLast or Family Name
Your Email. A copy of this form will be emailed to you when you submit it.
example@example.com
Any updates to your contact information (name, address, phone, email) for our membership roster?
None
Have you been vaccinated for COVID-19?
Would you like to be contacted for a one-on-one or group training session regarding the use of online tools for tutoring?
I am reporting my volunteer hours for the following period:
For the year:

Please tell us your TOTAL volunteer hours for this period. Include all learners & group classes, and use 'Other' for TALC meetings.

Rows	Teaching Hours	Preparation Hours	Travel Hours	Continuing Education Hours	Other Hours
Volunteer Hours

If you entered 'Continuing Education Hours', please describe your activities:
If you entered 'Other Hours', please describe your activities.
Are you assisting with any TALC group classes?
Are you presently placed with an individual student? Please select 'Yes', even if you have stopped meeting.
What is your individual learner's name?

First NameLast or Family Name
Share recent student successes, life advances or challenges with this learner:
Are you actively tutoring this learner?
Approximately when did you stop tutoring this learner?

MonthDayYear
Date
What is the primary reason that you are no longer tutoring this learner?
If you have additional learners, please provide their names and relevant information on their status (as described above):
Name, active or inactive, successes and challenges
Are you ready for a new or additional learner?
With a new learner, I can meet during these times (choose all that apply):

Other
For my new learner, I would prefer this gender:
I would prefer to meet (Online, In Person):
TALC Tutors and learners meeting in-person choose a public place, often a library. If you intend any in-person meetings, please select all locations that are easy for you:
For my new learner, I would prefer this type of learner (ELL or ABE):
I would prefer an English Language Learner (ELL) from:
I would prefer to work with an English Language Learner (ELL) whose English is (check all that apply):
I would prefer an Adult Basic Education (ABE) learner that is:
I would prefer to work with an ABE or ELL student with this level of education (check all that apply):
Should be Empty: