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Volunteer Application
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First Name *
Last Name *
Street Address *
example: 123 Reading Road
City *
Zip Code *
Primary Phone Number *
Secondary Phone Number
Email Address *
Date of Birth *
Gender *
Highest Level of Education *
Please describe any health concerns
Please explain any criminal convictions
Tutoring Preferences
Preferred Student Type
Preferred Location for Tutoring
Availability (When is best for you to volunteer?) *
Check all that apply
Referral Source
(How did you hear about the CLC?)
Tutor Agreement
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 tutoring is for at least 2 hours per week for 12 months, unless otherwise specified. 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 *
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