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VOLUNTEER TUTOR APPLICATION

  1. Volunteer Tutor Application banner.jpg

  2. The following information is for statistical purposes. Please check the appropriate boxes.

  3. SEX*

  4. RACE*

  5. EDUCATION*

  6. EMPLOYMENT*

  7. Check all that apply:*

  8. Check all that apply:*

  9. Check all that apply:

  10. AVAILABILITY

  11. Anytime:*

  12. Check boxes of days & times you are available.

  13.                                       Mornings                       Afternoons                      Evenings



  14. Mon.

  15. Check all that apply:



  16. Tues.

  17. Check all that apply:



  18. Wed.

  19. Check all that apply:



  20. Thurs.

  21. Check all that apply:



  22. Fri.

  23. Check all that apply:



  24. Sat.

  25. Check all that apply:

  26. I can commit to:*

  27. I prefer volunteering at the following GNLV location:*

  28. Do you have physical, mental or medical disabilities that would interfere with your ability to perform your duties with Greater Norwalk Literacy Volunteers?*

  29. Have you ever been convicted of a crime other than a misdemeanor?*

  30. PROFESSIONAL REFERENCES: Provide work/volunteer references who are not relatives.

  31. NAME

  32. RELATIONSHIP

  33. PHONE

  34. EMERGENCY CONTACT NAME:

  35. Applicant's Statement:

    I understand that the information given on this application is subject to review and that incorrect or misleading information renders this application void. I understand that Greater Norwalk Literacy Volunteers at Norwalk Public Library reserves the right to accept or reject applicants.

  36. Leave This Blank:

  37. This field is not part of the form submission.