Volunteer to Tutor

Last Name:
First Name:
Middle Name:

Email Address:
UVID:
Phone Number:

Address:
City:

Instructor's Email:
Class:
Section:

Service Learning? Yes    No
Spanish Speaking? Yes    No
Transportation? Yes    No

Are you willing to accept training, and direct supervision from teachers, coordinators, and others involved in the program administration?
Yes*    No
*By selecting yes, you signify that you are willing to participate in various trainings, supervision, etc.

Commitment Length:
Hours
Weeks
Start Date

Please rate your preference from 1 (high) to 5 (low). Please note the days, times, and age range of each of the sites.
  Site 1: American Fork, Mon-Fri, 3:45pm-4:40pm, K-8th grade
  Site 2: Lehi, Mon-Thurs, 3:00-6:00pm, 6yrs-12yrs
   Site 3: Lehi, Mon-Thurs, 9:30-11:30am, 4yrs-5yrs
   Site 4 & 5: Orem, Mon-Fri, 8:00am-3:30pm, K-6th grade, (Education major preferred)
   Site 6: Orem, Tues-Fri, 3:00-5:30pm, K-6th grade
  Site 7: Orem, Tues-Fri, 11:00-11:30pm, 7th-9th grade
  Site 8: Orem, Mon-Fri, 3:00-5:00pm, M 2-5, 1st-6th grade
  Site 9: Provo, Mon-Fri, 8:00am-3:30pm, K-6th grade, (Spanish speaking preferred)
   Site 10: Provo, Mon-Thurs, 3:00-5:00pm, K-6th grade
   Site 11: Provo, Mon-Thurs, 3:00-5:15pm, K-5th grade
  Site 12: Provo, Mon-Fri, 3:00-5:00pm, 7th-12th grade

Emergency Notification: Name
Phone Number
Relationship

Reference: Name
Phone Number
Relationship

Reference: Name
Phone Number
Relationship

Questions? Concerns? Please contact Bethany Hirsh 801-863-6372 bethany@uvu.edu, or Rachelle Shute 801-863-6310 rachelles@uvu.edu

Comments: