Richardson Adult Literacy Center: TUTOR DATA SHEET
Please print clearly and fill in all information.
Please print clearly and fill in all information.
Today’s date _________________________
m d y
LAST NAME ____________________________________________FIRST NAME _________________________
HOME ADDRESS ______________________________________________________________APT___________
ZIP CODE _________________ CITY __________________________________ STATE __________________
E-
BIRTHDATE (optional) _________________________ Check One: MALE _____ FEMALE _____
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ETHNICITY Circle One:
Asian Black Hispanic Native American Pacific Islander White
HOME PHONE _____________________________ CELL PHONE _______________________________
Where are you employed? ________________________________________________________________________
How did you hear about RALC? ___________________________________________________________________
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Preferred Tutor Times ______________________________ Preferred Day(s) _____________________________
ABOUT YOU
Special Skills and/or Interests ______________________________________________________________
Areas or Fields of Work Expertise __________________________________________________________
Languages you know ____________________________________________________________________
EDUCATION Circle One:
HS GED Other College: 13 14 15 16 Graduate: 17 18 19 20
Degrees/Certifications/Special Studies _______________________________________________________
Other comments regarding placement ______________________________________________________________
RALC Tutoring Policy
Volunteer tutors will meet their students in public places.
Tutors and students will provide their own transportation to and from the meeting place.
Tutors and students will provide their own transportation to and from the meeting place.
I have read and understand the RALC Tutoring Policy:
TUTOR REGISTRATION