Modesto Stanislaus NAACP
Tutor Application (Homework Support Program)
Position applying for
Please Select
Tutor
Coordinator
Volunteer
Last
First
M.I.
Street Address
Apt/Unit #
Phone
City
State
Zip Code
Email
example@example.com
Education
Complete for high school students only
High School
Year
Grade
When do you graduate?
Do you have a work permit?
Please Select
Yes
No
College
If applicable
College Address
Degree
If applicable
References
Please list at least one professional reference
Full name
Relationship
Company
Phone
Address
Email
example@example.com
Full name
Relationship
Company
Phone
Address
Email
example@example.com
List at least one character reference
Full name
Relationship
Company
Phone
Date
/
Month
/
Day
Year
Date
Address
Email
example@example.com
Previous Employment
Company
Phone
Address
Supervisor
Job title
From
To
Responsibilities
Would it be possible for us to reach out to your previous supervisor for a reference?
Please Select
Yes
No
Company
Phone
Address
Supervisor
Job title
From
To
Responsibilities
Would it be possible for us to reach out to your previous supervisor for a reference?
Please Select
Yes
No
The tutor's general work schedule is set between 1pm and 6pm, Monday - Friday
Number of preferred hours per week
Days available to work (Check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Tutors are required to provide their own transportation to school sites. Do you have transportation?
Yes
No
Please write a paragraph describing your qualifications to tutor grade or middle school students.
What special skills do you possess to assist students with their homework and enhance their self esteem?
We encourage you to attach a cover letter and resume with your application
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Signature and Disclaimer
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature:
Date
/
Month
/
Day
Year
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