With What Level(S) Are You Most Interested in Working?

Tutor Application

LAST NAME / FIRST NAME / MI / DATE OF BIRTH
STREET ADDRESS / CITY / STATE / ZIPCODE
SOCIAL SECURITY # / PHONE (BEST CONTACT) / 2ND PHONE / DRIVERS LICENSE
EMAIL ADDRESS / Best way to contact you: email or phone? / Have you ever been convicted of a felony?
AVAILABILITY:
_____ MON: ______THU: ______
_____ TUES: ______FRI: ______
_____ WED: ______SAT: ______
DATE AVAILABLE TO BEGIN TUTORING: / PLEASE CHECK THE GEOGRAPHIC AREA(S) IN WHICH
YOU ARE AVAILABLE TO TUTOR:
_____ Charleston _____ Summerville ______Goose Creek
_____ Mt. Pleasant _____ Moncks Corner ______Hanahan
_____ James Island _____ West Ashley ______North Charleston
Other (please specify): ______

AREAS OF EXPERTISE

WITH WHAT LEVEL(S) ARE YOU MOST INTERESTED IN WORKING?

Early Childhood/Preschool
(K – 2) / Elementary School
(3 – 5) /
Middle School
(6 – 8) / Secondary
(9 – 12) / College/ Adult

PLEASE CHECK ALL THAT APPLY: PLEASE CHECK YOUR CURRENT STATUS:

Basic / Calculus I / High School graduate
(not currently in college) / Certified Teacher in
______
Algebra I / Calculus II
Algebra II / GED Prep / College Student
Year: ____ Major: ______/ Certified Teacher with Masters
Degree in Education
Geometry / SAT/ACT Prep
Trigonometry / Advanced Testing Prep / College Student pursuing an Math/Math Education degree / Masters Degree other than Education
Other: (please specify)
College degree other than Ed. / Other: ______

EDUCATION

FROM / TO / NAME & LOCATION OF SCHOOL / DEGREE

CURRENT (OR RECENT PAST) EMPLOYMENT

PLACE OF EMPLOYMENT / LOCATION / BASIC SCHEDULE / HOW LONG HAVE YOU WORKED THERE? / ARE YOU CURRENTLY WORKING THERE? / IS THE JOB RELATED TO EDUCATION?

PLEASE EXPLAIN ANY ADDITIONAL EXPERIENCE YOU HAVE IN THE FIELD OF EDUCATION (ESPECIALLY MATH), TUTORING, WORKING WITH CHILDREN, ETC.

REFERENCES

NAME / ADDRESS / PHONE / EMAIL / RELATIONSHIP

· 106 Hemingway Circle Summerville, SC 29483 · email: · (843) 214-0548