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Tutor Application

 
By checking the box below, I understand and acknowledge that I am submitting an application for employment, and that I may be subjected to a credit and background check as a condition of employment.  However, I am assured that
my information is confidential, is never shared, and is only used for the purpose of pre-qualifying me as a prospective teacher/tutor for the Waiting To Excel Tutoring Program. 



Personal Information (* indicates optional information)

Name:  DOB (mm/dd/yyy) 

Country:  State: 

City/Providence:   County:    

Street Address: 

Primary Phone: Alternate Phone: 

Email:

Emergency Contact  Phone: 

*Occupation:  *Martial Status:  *Race:  

 
Education

Highest Grade Completed (plese check one): 

PhD  MA  BA  AA  College  GED  12  11  10  9  8

Field of Study:   Degree Received (mm/yy):

Last School Attended:

Location:

 
Preferred Subjects

What subject(s) or area(s) of study would you like to tutor?

Basic Math  Reading  Writing  History  Literature  Health Science

Geography  Social Studies Language Arts Humanities  Religion

Algebra Geometry  Physics  Statistics   Probability  Calculus

GED  ESL  Computers  Test-Taking  Note-Taking  College Prep

Foreign Language(s):   Business/Accounting

MS Word  MS Excel  MS PowerPoint  MS Access  MS Publisher

  

Preferred Grade Levels

I feel most comfortable tutoring (please check all that apply):

PreK-3     4-6      7-8      9-12      ABE      LEP      LD      College

  

Teaching/Tutoring Experience & Background

No. of total years teaching/tutoring:    Dates: 

Subjects:

Last School/Organization: 

Address: 

Teaching/Tutoring Certification(s) - Include certifying organization and expiration dates:

Professional Memberships, Awards, or Offices Held:

Computer Software/Hardware Knowledge or Certification(s):

Other Special Skills/Knowledge/Languages Spoke other than English:

  

Referral

How did you hear about the Waiing To Excel Tutoring Program?

Flyer       Newspaper      Newsletter     Radio       TV        Web Search

Elementary School     Junior High School      High School     Charter School  

Direct Mail         Email        Church      Community Org      Relative/Friend

  

Self Certification

I certify that, if need be, I would qualify for a fingerprint card

I certify that, if need be, I would pass a background check

I certify that the foregoing information I have provided is true and correct to the best of my knowledge.  I understand that if I have falsified any information, I will be immediately disqualified as a candidate for employment with the Waiting To Excel Tutoring Program and any of its affilitate programs and organizations

 
Please contact me by:
       Email          Telephone             Postal Mail

Become a Certified Tutor and increase your pay rate and your employability!

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