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©2009 Family Literacy Centers, Inc.

Family Literacy Volunteer Registration Form

( * ) Indicates field is required.

Contact Information


Name
First*MILast*
   
Address
City/ST/Zip  
Phone
(xxx-xxx-xxxx)
Home*BusinessCell
   
Email*

Personal Information

Where do you prefer to meet?*
Birthdate* (mm/dd/yyyy)   Gender 
Ethnic Background  Marital Status
Employer
School Attending Grade 

Emergency Contact Information


Contact
NameTypePhone
Emergency Medications

Availability Information

When is the best time to reach you?
Times available*
MonTueWedThuFri
From
Until

Other Information

Other Schooling, Training,
or Work Experience
Interests or Hobbies
Talents or Skills
Languages that you know,
other than English
How Did You Hear About Family Literacy?

Volunteer Information

Why Do You Want to Become
a Family Literacy Volunteer?*
Have you Ever Been
Convicted of a Felony?*
If asked, Would you Submit
to a Background Check?*
Other Information
Periodically we need volunteers to help in areas other than tutoring. If you would ever be interested in helping with any of the following, please check the box to the left.
TypingOffice/Clerical
PhoningPublicity
Fund RaisingHost Tutor Workshops
Helping with Awareness BoothsGiving Computer Help
Helping with Socials and ActivitiesTeaching Other Subjects
Bookkeeping/AccountingNewsletter/Editing/Writing
Public SpeakingTeaching Small Groups of Students
Teaching Reading to ChildrenDrama/Improvisation Group
Video TapingMaking Copies of Video Tapes
Grant Writing/ResearchTutor Trainer
EvaluatorGrade Level Books
Other
Family Literacy Volunteer Agreement

I would like to volunteer for Family Literacy. I agree to perform the duties described below to the best of my ability and in a professional way.

I will prepare well, and spend at least 1 hour, twice a week, as far as practical, tutoring my student, encouraging and appreciating my student's efforts.

I will keep accurate records of my tutoring and preparation hours and report them at the end of each month to the Family Literacy Office by the 5th day of each month.

If a problem arises with scheduling, I will notify my student as soon as possible (ideally 12 hours in advance). If my student continually misses appointments or quits, I will notify the office to be reassigned.

I will attend the specified volunteer training's, including the In-service Workshops: Continually striving to upgrade my human service skills and broaden my abilities as a tutor.

I understand that Family Literacy or I can cancel this agreement at any time if illness or any unforeseeable problems arise by contacting the other party.

I understand that my work will be evaluated and records kept which will enable me to document my volunteer work experience for future job applications.

CONFIDENTIALITY: I understand the importance of keeping names of students and of other tutors strictly confidential.