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Multicultural Counseling and Research Center
Volunteer Tutor Application
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Today's Date
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Full Name (First, Middle and Last)
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Your answer
Date of Birth
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MM
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YYYY
Home Address
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Your answer
Phone Number
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Your answer
Education
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Your answer
Do you have previous volunteer or teaching/tutoring experiences? If so, please describe.
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Your answer
Why are you interested in volunteering?
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Your answer
Do you speak a second language? If so, what language?
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Your answer
When would you be available to start?
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MM
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DD
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What day(s) of the week and time(s) would you be available to tutor?
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Your answer
How many hours a week would you be available?
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1 hour
2 hours
3 hours
4+ hours
Other:
How far are you willing to travel (e.g., 45 minutes or less)? If starting location is different than home address, please enter the address below (e.g., work address).
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Your answer
How did you hear about this opportunity?
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Your answer
Have you ever been convicted of a crime? If yes, please describe.
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Your answer
Do you consent to a background check?
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Yes
No
Please list two references, preferably someone you have worked or volunteered with. No family members. List name, address, relationship and phone number.
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Your answer
Do you have access to transportation?
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Yes
No
Anything else you would like us to know?
Your answer
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