Tutor Application

Upward Bound Frostburg State University

Upward Bound Tutor Application

Please check the following high school course(s) in which you feel you could effectively tutor:
Please check the following high school subject areas in which you feel you could effectively tutor:*

Basic MathAlgebra 1Algebra 2GeometryTrigonometryCalculusBiologyChemistryPhysicsEnglishSpanish
Name (First, MI, Last)*
Local Address (If on campus, building & room number)*
Home/Permanent Address (include city, state, zip)*
Email Address*
example@example.com
What is your current class standing?*

FreshmanSophomoreJuniorSeniorGrad SchoolOther
Major(s)*
Minor(s)
GPA in Major_*
Cumulative GPA*
Work Experience 1 - Employer (Company Name)
Work Experience 1 - Supervisor Name (First and Last)
Work Experience 1 - Position Title
Work Experience 1 - Supervisor Phone Number
Work Experience 1 - Supervisor Email Address
Work Experience 1 - Employment Start Date

MonthDayYear
Date
Work Experience 1 - Employment End Date

MonthDayYear
Date
Work Experience 1 - Brief Job Description
Work Experience 2 - Employer (Company Name)
Work Experience 2 - Supervisor Name (First and Last)
Work Experience 2 - Position Title
Work Experience 2 - Supervisor Phone Number
Work Experience 2 - Supervisor Email Address
Work Experience 2 - Employment Start Date

MonthDayYear
Date
Work Experience 2 - Employment End Date

MonthDayYear
Date
Work Experience 2 - Brief Job Description
Work Experience 3 - Employer (Company Name)
Work Experience 3 - Supervisor Name (First and Last)
Work Experience 3 - Position Title
Work Experience 3 - Supervisor Phone Number
Work Experience 3 - Supervisor Email Address
Work Experience 3 - Employment Start Date

MonthDayYear
Date
Work Experience 3 - Employment End Date

MonthDayYear
Date
Work Experience 3 - Brief Job Description
Volunteer Experience 1 - Organization Name
Volunteer Experience 1 - Position Title
Volunteer Experience 1 - Contact Person (First and Last Name)
Volunteer Experience 1 - Contact Person Phone Number
Please enter a valid phone number.
Volunteer Experience 1 - Contact Person Email Address
Volunteer Experience 1 - Start Date

MonthDayYear
Date
Volunteer Experience 1 - End Date

MonthDayYear
Date
Volunteer Experience 1 - Brief Job Description
Volunteer Experience 2 - Organization Name
Volunteer Experience 2 - Position Title
Volunteer Experience 2 - Contact Person (First and Last Name)
Volunteer Experience 2 - Contact Person Phone Number
Please enter a valid phone number.
Volunteer Experience 2 - Contact Person Email Address
Volunteer Experience 2 - Start Date

MonthDayYear
Date
Volunteer Experience 2 - End Date

MonthDayYear
Date
Volunteer Experience 2 - Brief Job Description
Internship - Organization Name
Internship - Position Title
Internship - Contact Person (First and Last Name)
Internship - Contact Person Phone Number
Please enter a valid phone number.
Internship - Contact Person Email Address
Internship Start Date

MonthDayYear
Date
Internship End Date

MonthDayYear
Date
Internship - Brief Job Description
Hobbies or Areas of Interest
Clubs/Organizations you belong to or have belonged to in the past.
Reference 1 Name (First and Last)*
Reference 1 Address (Include City, State, Zip)
Reference 1 Title/Relationship*
Reference 1 Phone Number
Reference 1 Email Address
example@example.com
Reference 2 Name (First and Last)*
Reference 2 Address (Include City, State, Zip)
Reference 2 Title/Relationship*
Reference 2 Phone Number
Reference 2 Email Address
example@example.com
Reference 3 Name (First and Last)*
Reference 3 Address (Include City, State, Zip)
Reference 3 Title/Relationship*
Reference 3 Phone Number
Reference 3 Email Address
example@example.com
The Upward Bound Program is located at 7 American Avenue

Questions may be addressed to (301) 687-4994

I certify that the information given in this application is correct.
Signature*

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Date*

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