Escondido Public Library - Literacy Tutor Registration

Name

Address (street, city, state, zip)

Phone number

E-mail address

How did you hear about Literacy Services?
An adult learner
A co-worker
Another volunteer
Radio/TV
Newspapers/magazines
Library
Church/community organization
Other

Present employer (if applicable)

Occupation/position

Education background: Select highest level completed
GED
high school diploma
business/technical school
A.A.
B.A./B.S.
M.A./M.S.
Ph.D

From which college/university did you graduate (if applicable)?

Specialized courses or skills (please list)

Do you have prior teaching experience? If so, please describe:

Have you been a tutor before? If so, please describe:

Why are you interested in tutoring?

Please list any other volunteer work

Can you make a six month commitment to this program after tutor training?

Would you like to volunteer in the Literacy Services office on occasion?

Would you like to help us with special events?

We use the following information for statistics. Completion of this section is optional.

Question 19
Male
Female

Question 20
16-19
20-29
30-39
40-49
50-59
60-69
70-79
80+

Question 21
Asian
African American
Latino
Native American/Alaskan Native
White
Other