TUTOR APPLICATION FORM Volunteer InformationName(Required) First Last Date of birth(Required) MM slash DD slash YYYY Address(Required) Street Address City State / Province / Region ZIP / Postal Code County(Required)SelectAtlantic CapeBurlingtonGloucesterMercerMiddlesexMonmouthOceanSussexUnionWest HudsonHome phoneCell phone(Required)Email(Required) Best way to reach you Home Phone Cell Phone Email Emergency contact nameRelationshipEmergency phoneNative languageIn your native language Speak Read Write What other languages do you speak?Race/Ethnicity Native American Hispanic/Latino White Asian Black/African American Other... Sex Male Female Other Prefer Not To Say OtherEducationPlease check your level of education High School Some college Undergraduate Graduate Doctorate Major/Area of Study/CertificateWork InformationAre you presently Employed Unemployed Retired Student Name of employerAvailabilityWhen are you available for volunteer work? Weekdays Weekends Saturday only Sundays only Mornings Afternoons Evenings Occasionally On call For emergencies Other... I prefer to work Alone With others Indoors Outdoors In a busy setting In a quiet place With lots of freedom Other... Are you interested in tutoring adults? Yes No If there is an option, when would you prefer to attend training? Daytime Evening Tutoring is currently being offered online. In general, are you interested in tutoring: Online In-person Source of ReferralHow did you learn about volunteering with Literacy NJ? TV Radio Friend/family Employer Library Special event PR talk Other literacy organization Newspaper Internet Other... Volunteer InterestVolunteer Skills Inventory Editing Grant writing Graphic Design Photography Proofreading/mailings Videography Microsoft Office Computer repair Database management Event planning Marketing/PR Notary Public Public speaking Research Fundraising Social Media Committee management Other languages Other... Have you volunteered for organizations in the past? Yes No Do you have a valid driver's license in the state of NJ? Yes No Are you willing to attend and complete training for the volunteer position in which you are interested? Yes No Can you commit to volunteer for at least one year? Yes No Are you volunteering to meet a requirement? Yes No Is there any other information you wish to share about your desire to volunteer?