Volunteer Tutor Application Form

Literacy Central Vancouver Island

Volunteer Tutor Application Form
Volunteer Tutor Application Form

We have a screening process for volunteers. You will require an orientation and interview. We also provide training; the length of training required is dependent upon your background and area you wish to volunteer with us.
Name

First NameLast Name
ADDRESS
Street
City
Postal Code
CONTACT DETAILS
Phone
Cell
Email
example@example.com
EMERGENCY CONTACT
Name
Phone Number
EXPERIENCE
Education

High SchoolPost SecondaryTESOLTeacher TrainingTutor TrainingOther
CURRENT EMPLOYMENT STATUS
WORK EXPERIENCE
VOLUNTEER EXPERIENCE
RELEVANT SKILLS AND INTERESTS
VOLUNTEER GOALS
Areas of volunteer interest

One-to-One TutoringGroup Classes / WorkshopsSocial EventsFundraisingOther
What are your tutoring goals?
Why do you want to be a tutor?
Why do you want to volunteer with us?
How did you hear about us?
AVAILABILITY
Where are you able to volunteer?

LCVI (19 Commercial Street)OnlineAnywhere around Central Vancouver Island
What days of the week work best to volunteer? (check all that apply)

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What times of the day are you available? (check all that apply)

Morning (9am - 12pm)Afternoon (12pm - 5pm)Evening (5pm - 8pm)
REFERENCES
Reference #1 - Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Reference #2 - Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Media Release
Consent for Media

I agree LCVI can use my name or any photos of me taken at LCVI or my written comments for use in promotional materials/media.
Volunteer Tutor Requirements
Volunteers are required to complete a Criminal Record Check and provide two references.

Tutors are asked to commit to a minimum of six months, for an average of three hours per week at a public location.

Tutor volunteers are required to participate in the LCVI training course and in professional development opporuntitines, when possible

Tutor volunteers will also need to submit monthly progress reports to the Tutor Coordinator.

By signing below, you are agreeing the volunteer tutor requirements.
Signature
Date

MonthDayYear
Date
Collection and Use of Information. All information collected is subject to the provisions of the Freedom of Information and Protection of Privacy Act and will only be used for program administration and administrative purposes of Literacy Central Vancouver Island. By signing this form you are consenting to the collection, disclosure and use of your personal information for the purposes stated above.
Should be Empty:

Literacy Central Vancouver Island

Volunteer Tutor Application Form

ADDRESS

CONTACT DETAILS

EMERGENCY CONTACT

EXPERIENCE

VOLUNTEER GOALS

AVAILABILITY

REFERENCES

Media Release

Volunteer Tutor Requirements