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Adult Volunteer Literacy Tutor Program Student Registration Form
For which of the following subjects are you requesting a tutor?
Math
Reading
Writing
English Language
Work Related
(Please specify occupation.)
Please select all locations for which you may be available:
MCC Campus
Algonquin
Cary
Crystal Lake
Fox River Grove
Harvard
Huntley
Island Lake
Johnsburg
Marengo
McHenry
Richmond
Wonder Lake
Woodstock
Other Location
In the spaces below, write the times you are available for each day. (Be as flexible as possible, the more days and times you are available the quicker you can be placed with a volunteer.)
Day
Morning
Afternoon
Evening
Notes
Monday
DayMondayMorning
DayMondayAfternoon
DayMondayEvening
Tuesday
DayTuesdayMorning
DayTuesdayAfternoon
DayTuesdayEvening
Wednesday
DayWednesdayMorning
DayWednesdayAfternoon
DayWednesdayEvening
Thursday
DayThursdayMorning
DayThursdayAfternoon
DayThursdayEvening
Friday
DayFridayMorning
DayFridayAfternoon
DayFridayEvening
Saturday
DaySaturdayMorning
DaySaturdayAfternoon
DaySaturdayEvening
Sunday
DaySundayMorning
DaySundayAfternoon
DaySundayEvening
To help us assess your needs, please answer the following questions in
ENGLISH
1. Tell us about yourself and your family. For example: are you married, do you have children, etc.
2.Describe where you lived as a child.
3. What are some important things you want to learn?
4. What do you like to do in your free time?
5. Why do you want to learn English?
Student Commitment Contract
Before a student is placed with a tutor, an agreement between the literacy program and the student must be made. The student must read and sign this form before a student is matched with a volunteer tutor.
1. The student must take both pre and posttests. Student will be notified when post testing is necessary. Student must come to McHenry County College, Adult Education Office, Room A362, for testing when requested.
2. If a student is unable to attend an appointed meeting time with a volunteer tutor, the student must call the volunteer tutor and inform him or her. Advanced notice of at least 4 hours is required. Two (2) unexcused absences will result in being dropped from the program.
3. If the student must miss their tutoring time for more than two weeks, the student must notify the volunteer tutor in advance.
4. Respect for property and adherence to the rules set by the tutoring site is expected. Each church, public library, or other tutoring site will have specific guidelines that must be followed
5. If the student decides he/she no longer wishes to meet with a volunteer tutor, the student must call the Adult Education Office at (815) 455-8752.
Release of Personal Information
I authorize the Adult Volunteer Literacy program of McHenry County College to provide my contact and testing information to a volunteer tutor.
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Last Name
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Submit