Student Application
You can apply for a one-on-one tutor only if you live or work in Wayne County.
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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 *
Gender *
Date of Birth *
Place of Birth *
Primary Language *
Highest Level of Education *
Did you attend school in the US? *
Are you employed? *
How many children or grandchildren do you have under the age of 18?
If you have children or grandchildren, how old are they?
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Availability (check all that apply) *
The more available you are, the sooner you will receive a tutor
Lived in the US since what year?
Describe any health concerns or learning disabilities that your tutor should know about:
Explain any crime convictions:
Student Terms of 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 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.

CLC's Inclusion and Anti-Harassment Policy: At CLC we work with people from many different cultures and backgrounds. CLC is a safe place, absent of xenophobic, racist, and sexist language and behavior. Further, sexual harassment of any form will not be tolerated. Our values at CLC support our beliefs of inclusivity and respect for all people. Our students are shown the kindness, respect, and grace that each member of our CLC family deserves, so that they may thrive in our community. Violation of this policy will result in the termination of participation in CLC's programs.

I affirm by my electronic signature below that all of the information stated above is true and accurate to the best of my knowledge. I agree to abide by the Student Terms of Agreement and CLC"s Inclusion and Anti-Harassment Policy.  I understand that any violation of these terms will result in my dismissal.
Type name below to accept terms of agreement *
Referral Source
(How did you hear about the CLC?)
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