Tutor Registration Form
Last Name: *
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First Name: *
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Street: *
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Street 2:
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City: *
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State: *
Zip: *
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Phone Number: *
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Alternate Phone Number:
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Email: *
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Demographics
We'd like to learn a few things about you for database purposes.
Birth date: *
xx/xx/xxxx
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Ethnicity: *
Gender: *
Education: *
Employment Status: *
Volunteer Questionnaire & History
How did you learn about us? *
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Tutoring adults is a rewarding and challenging experience. Why do you want to volunteer with Learn to Read?
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LTR requires that tutors commit to volunteer for 6 months and meet with students for at least one and a half hours per week. Will this be possible for you? *
Do you have any experience working with adults? *
Special Skills or Hobbies:
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Are you fluent in any languages besides English?
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Please list previous volunteer experience starting from the most recent.
Organization:
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From:
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To:
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Duties assigned:
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Supervisor's name:
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Supervisor's Phone Number:
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May we call this person?
Organization(2nd):
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From(2nd):
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To(2nd):
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Duties assigned(2nd):
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Supervisor's name(2nd):
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Supervisor's Phone Number(2nd):
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May we call this person(2nd)?
Organization(3rd):
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From(3rd):
MM
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DD
/
YYYY
To(3rd):
MM
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DD
/
YYYY
Duties assigned(3rd):
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Supervisor's name(3rd):
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Supervisor's Phone Number(3rd):
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May we call this person(3rd)?
Previous work experience:
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