Jewel Minds Tutor Application Form
Apply to become a tutor with Jewel Minds. Please complete all sections to help us understand your experience, skills, and fit for our team.
SECTION 1 — Personal Information
Tell us about yourself.
Full Name
*
First Name
Last Name
Pronouns
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City/State
*
Time Zone
*
Are you legally authorized to work in the United States?
*
Yes
No
Preferred method of communication
*
Email
Text
Phone
SECTION 2 — Educational Background
Share your academic qualifications.
Highest degree earned
*
Bachelor’s
Master’s
Doctorate
Other
Institution Name
*
Major / Area of Study
*
GPA (optional)
Relevant certifications
NYS Teaching Certification
Special Education Certification
TESOL/ESL
Reading Specialist
Other
SECTION 3 — Teaching & Tutoring Experience
Describe your teaching and tutoring background.
Years of tutoring/teaching experience
*
0–1
2–3
4–6
7+
Grade levels taught
K–2
3–5
6–8
9–12
College
What subjects do you feel confident teaching?
*
Do you have experience working with students with IEPs, 504 plans, or learning differences?
*
Yes
No
If yes, please describe your experience.
Describe your teaching or tutoring style. What makes your instruction effective?
*
SECTION 4 — Instructional Skills & Philosophy
Share your instructional approach and philosophy.
How do you differentiate instruction for diverse learners?
*
How do you build rapport with students?
*
How do you handle a student who is disengaged or struggling emotionally?
*
What does culturally responsive teaching mean to you?
*
How do you incorporate executive functioning support into your sessions?
*
SECTION 5 — Availability & Logistics
Tell us when and how you are available.
Weekly availability
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred times
*
Available for in person sessions?
*
Yes
No
Available for virtual sessions?
*
Yes
No
Open to teaching group classes?
*
Yes
No
Available during school breaks/summer?
*
Yes
No
Earliest start date
*
SECTION 6 — Technology & Tools
Technology requirements for tutoring.
Do you have reliable Wi Fi?
*
Yes
No
Do you have a working laptop or tablet?
*
Yes
No
Comfortable using Google Docs, Zoom, and digital organizers?
*
Yes
No
Comfortable learning new instructional tools?
*
Yes
No
SECTION 7 — Alignment With Jewel Minds
Your fit with our mission and services.
Why do you want to work with Jewel Minds?
*
Which service tiers are you comfortable delivering?
*
Foundations (Tier 1)
Momentum (Tier 2)
Brilliance (Tier 3)
Group Programs
Add On Services
Will you use Jewel Minds templates and materials?
*
Yes
No
Comfortable completing session notes, check ins, and progress trackers?
*
Yes
No
Willing to participate in periodic training sessions?
*
Yes
No
SECTION 8 — Compensation & Commitment
Compensation and commitment expectations.
Are you comfortable with the Jewel Minds compensation structure (60–70% depending on tier)?
*
Yes
No
Are you willing to commit to at least one full semester?
*
Yes
No
Submit Application
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