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Tutor monthly report form
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* Indicates required question
Email
*
Your email
Tutor's Name
*
(First Last)
Your answer
Student Name
(First Last)
Your answer
Month being reported
*
Choose
January
February
March
April
May
June
July
August
September
October
November
December
Year
*
Your answer
Student Achievements this month
Please let us know if your student has accomplished a goal!
Community Goals
Gotten a library card
Became a citizen
Got a driver's license
had a meaningful conversation with someone in the community
Other:
Employment or financial Goals
Had a job interview
Got a job
Got a raise or promotion
Had a meaningful interaction with an employer or customer
Other:
Education Goals
Completed a skill book level
Started another educational program
Was able to read an instructional text in English
Other:
Health Goals
Was able to communicate with a healthcare provider in English
Made an appointment for health care in English
Understood the directions of a medical care provider
Other:
Life Skills and Daily Life Goals
Feels like reading English is easier
Completed official forms
Wrote correspondence (i.e. letter or email)
Wrote a check
Read in English for pleasure or interest
Used English on the phone (ESL student)
Other:
Parenting and Family Life Goals
Read to a child
Spoke to or corresponded with a teacher in English
Spoke with their child/family member in English
Helped child with homework
Was able to read product labels when shopping
Was able to make price comparisons when shopping
Other:
Additional Comments
Your answer
Lessons and Progress
Hours Tutoring
*
Your answer
Prep Hours and Travel Time
*
Your answer
Laubach, LifePrints, or other book level
Level 1
Level 2
Level 3
Level 4
Other:
Clear selection
Please list any supplemental books/materials you are using
Your answer
Contact Information Update
Please let us know if you or your student has changed contact info
These changes apply to:
Me
My student
Clear selection
Address
Your answer
Telephone
Your answer
Email
Your answer
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