Literacy Council Monthly Tutor Report Entry Form
Reporting Year and Month *
Tutor and Student identification Section
Tutor's First Name *
Your answer
Tutor's Last Name *
Your answer
Student's First Name *
Your answer
Student's Last Name *
Your answer
Where do you meet your student?
Lessons and Progress Section
Hours tutored *
Please round to nearest .25 hour
Your answer
Hours of preparation and travel *
Your answer
Hours volunteered (not related to tutoring) *
Your answer
Materials Section
Please check the Laubach book level you are currently using. If you are using different materials (e.g. driver's ed materials, Able books), check Other and indicate what you are using.
Laubach Way to Reading Level:
Laubach Way to English Level
Challenger Level:
Last Lesson Completed
Your answer
What supplementary materials are being used?
Student Goals Section
Please provide a comment listing any goals your student has achieved.
For example:
- got a job or a better job
- improved employability skills
- got a GED or other diploma
- entered other education or training
- improved score on standardized test
- advanced level in curriculum series
- obtained citizenship
- registered to vote or been able to vote
- obtained a driver's license
- increased involvement in community
- increased involvement in child's education
- attained consumer skills
- attained wellness and healthy lifestyle

Or, please list any personal goal that the student has attained.

Your answer
Share Comments Section
Please share any comments, details or observations here.
Your answer
Do we have your student's permission to announce this month's achievements in the next newsletter?
How can we help you?
How are things going? What do you need to make you more effective?
Your answer
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