Volunteer Candidate Registration Form

Name*

First NameLast Name

E-mail*

Birth Date*

MonthDayYear

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Emergency Contact (name & number)*

Highest grade or degree completed*

Teaching or other relevant experience*

Present Occupation*

I would be willing to work with a student

MorningAfternoonEvening

I am available to meet with students:

We help adults:
· Learn or improve English
· Become US citizens
· Learn to read or improve reading skills
· Improve writing skills
· Improve math skills
· Learn or improve digital literacy skills
· Complete high school diploma
· Pass their high school equivalency tests
· Prepare for a test: driver’s manual, electrician, police, Accuplacer, etc.

Please indicate areas to volunteer according to your skills:

Tutor - individual students or two or three students togetherTeam Tutor - work as part of a team working with a group of studentsTutor at Strafford County House of CorrectionsChildcare Help - our Childcare Program runs during dayclasses in DoverComputer Lab Proctor - help in our open computer lab times in the evening or during the day and/or in classes with our Technology IntegratorFloating Classroom Aide - assist teachers during day orevening classes in either Dover or in RochesterAdministrative Aides - Be part of a team who helps with various office tasks from answering phones, copying, and filing to setting up and monitoring student testing sessions. (Day and evening times available in both Dover and Rochester locations)Volunteers to help with special events such as graduation, culture celebration, mid- and end-of-year celebrationsDrive students to and from classes.

Would you be willing to work with:

a student who is developmentally disabled?a student who is physically disabled?

Do you have transportation?

How far would you be willing to travel?

Do you speak any language in addition to English?

What are some of your interests or hobbies?

How did you learn about the Tutorial Program?

Why would you like to be a volunteer tutor?

Volunteer Registration