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CENTRAL OREGON COMMUNITY COLLEGE

Adult Basic Education Department

TUTOR APPLICATION AND PROFILE

Please print or type; answer every question clearly and completely.

Last Name                                                             First Name                                                                             Middle Initial

Street Address                                                     Mailing Address                                  City                         State       Zip

Day Telephone Number                      Evening Telephone Number                              Cell/Message phone (if different)

Present Occupation                                                                                                                             email address

List academic training experience or personal characteristics that uniquely qualify you to teach others.

Level                 School Name                              Dates                      Location                                Major                    Degree  

GED                                                                                                                                                                                                       

High

School                                                                                                                                                                                                   

College                                                                                                                                                                                                  

Other                                                                                                                                                                                                     

References to be contacted:

                Name                                                      Address                                                                 Phone                  Checked?

1.                                                                                                                                                                                                            

2.                                                                                                                                                                                                            

3.                                                                                                                                                                                                            

Have you ever been convicted of a felony?                                                                                                                                   

Have you taught or tutored before?                   If so, what subject and age group?                                                                

Why do you want to be a tutor?                                                                                                                                                      

Have you had any experience in a foreign country?                                                                                                                     

        Foreign language:        Read                                                                                                                                                      

                                                Speak                                                                                                                                                    

Number of hours per week you can volunteer:                                                                                                                              

Additional volunteer activities include student recruitment, curriculum development, tutor support, and records maintenance. Which would you be interested in doing, if not working in the classroom?

I would like to tutor:                            reading                                                                                   English/spelling

                                                                foreign students (ESL)                                                        arithmetic

                                                                Other (specify)                                                                                                                    

Which days are best for you to tutor or help? Circle:    Monday   Tuesday   Wed   Thursday   Friday   Sat   Sunday

What time of day is best for you?                                                                                                                                                    

Where would you prefer to tutor:                     COCC classroom                                                  library

                                                                                my home                                                                student’s home

                                                                                Other (specify)                                                                                                    

Write a brief profile of yourself and include your interests and hobbies:                                                                                 

Please note any health problems, medications being taken, and the name of the physician or person to be notified in the event of an emergency:                                                                                                                                                           

List any paid or volunteer positions you have held.

Dates      Employer                                                               Location                                                Duties                                                   

I understand that volunteer tutor applicants must be approved by COCC staff and that a need may not necessarily exist at this time for my services.

                                                                                                Applicant’s Signature                                                         Date

Staff comments based on interview:

                                                                                                COCC Staff’s Signature/Title                                             Date

Send signed application to the Tutor Coordinator, ABE, 2030 SE College Loop, Redmond OR 97756.