Tutor Application Form

The Smart Scribe Tutor Application

For Teachers & Tutors
Background Information
Full Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
E-mail Address
Birth Date

MonthDayYear
Male/Female

MaleFemale
Nationality
Your Skills & Qualifications
Why do you want to tutor? What are some of your skills and qualifications?
Please enter the age groups or grades that you prefer to tutor.
Have you tutored before? If yes, tell us about your experience(s) below.

YesNo
Please list the subjects and levels you are comfortable tutoring. You can list up to 6.
Subject No 1
Subject No 2
Subject No 3
Subject No 4
Subject No 5
Subject No 6
Your Education
Do you have a HS Diploma?

YesNoIn progress
Graduation Date?
Do you have a College Degree?

YesNoIn progress
Field of study? Graduation date?
Have you taken your SAT?

YesNo
Math Score
ReadingScore

Have you taken your Regents Exams? If yes, please enter your scores:

	English Language Arts CC	Integrated Algebra	US History & Government	Global History	Trigonometry	Geometry	Living Environment	Biology	Physics	Chemistry	Earth Science	Foreign Language (indicate lang.)
Scores

Eligibility
Do you consent to us conducting a background check?

YesNo
Are you legally eligible to work in the United States?

YesNo
Availability
Please tell us what your preferred hours to work are.
Which days are you able to tutor?
Are you currently employed?

YesNo
Tutoring Method

On-site (in-person)Remote (Google Meet or Zoom)Open to both
Advanced Skills
Please tell us of any special skills you may have (i.e.: bilingual, visual or vocal artist, etc).
Have you worked with children with disabilities?*

YesNo
If yes, in what capacity?
Getting to know you.
Please tell us a little more about yourself, what motivates you, your passions and plans.
We aim to provide a great match between the tutor and tutee (student). Please share some of your hobbies, talents and interests. Is there anything else you'd like us to know?
References
Please provide the names of two organizations or professionals (teacher, professor, supervisor, etc.) that we can use as references. (These cannot be family or friends)
First reference
Name
Telephone
Email
Profession/Relationship
Second reference
Name
Telephone
Email
Profession/Relationship
Do you know anyone else that would be a great tutor for The Smart Scribe?

YesNo
If "yes" - please provide their names and contact info below.
Should be Empty:

The Smart Scribe Tutor Application