Request edit access
You can apply for a one-on-one tutor only if you live or work in Wayne County.
example: 123 Reading Road
Primary Phone Number
Secondary Phone Number
Date of Birth
Place of Birth
Highest Level of Education
High School Diploma / GED
Less than 12 grade
Did you attend school in the US?
Are you employed?
Availability (check all that apply)
The more available you are, the sooner you will receive a tutor
If you have a learning disability, please describe below:
Lived in the US since what year?
Describe any health concerns
Explain any crime convictions
I agree to pay a registration fee of $25.00 to the Community Literacy Council, Inc. at the assessment meeting for a one-on-one tutor. I understand that all tutoring sponsored through the Community Literacy Council, Inc. must be held in a public location. I understand that my commitment to learning is for 1.5 hours per week for 6-12 months. Attendance or participation in Community Literacy Council activities constitutes consent to be photographed for use in print and /or electronic publicity for the Plymouth-Canton Community Literacy Council. I affirm by my signature below that all of the information stated above is true and accurate to the best of my knowledge.
Type name below to accept terms of agreement
(How did you hear about the CLC?)
Friend / Family
CLC business card
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This form was created inside of Plymouth-Canton Community Literacy Council.