Tutors

Name *
First
Last

Email *

Phone *

Street Address/PO Box

City

State

Zipcode

County

Do you have access to a computer or tablet? *
Yes
No

Do you have access to the internet? *
Yes
No

We currently provide tutoring in person and on Zoom. Which do you prefer? *
In Person
On Zoom

Attendance at a 2-hour Orientation Session is MANDATORY prior to attending 4 Tutor Training Workshops (12 hours). Please check your spam folder for any LCN correspondence. A PA criminal background check is also required (provided by LCN). Please choose from the following dates: *

Previous orientation date
If applicable, enter date of previous orientation session here.

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone Number

Birth Date

Gender
Male
Female
Other

Race
American Indian or Alaskan Native
Asian
African American/Black
Hispanic/Latino
Native Hawaiian/Pacific Islander
White

Do you have any educational certificates?
Adult Education
K - 12
Special Education
TESOL
Other

Highest Education
High School Diploma/GED
Some College Courses
Technical/Business School Certificate
Associate's Degree
Bachelor's Degree
Master's Degree
Doctoral Degree

Employment Status
Full Time
Part Time
Unemployed
Retired
Looking for work

Occupation

Employer

How did you hear about LCN?

Why are you interested in volunteering with LCN?

Additional comments: (copy)

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