Information for Potential Tutors

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Literacy Suffolk, Inc. An accredited ProLiteracy affiliate 627 N. Sunrise Service Road PO Box 9000 Bellport, NY 11713-9000 631.286.1649 631.286.1668 Fax admin@literacysuffolk.org www.literacysuffolk.org Information for Potential Tutors Literacy Suffolk holds 12-hour tutor training workshops in various library locations in Suffolk County. They are offered in 4 sessions of 3 hours each during the week or on Saturdays mornings. Attendance at all sessions of the workshop is required. Tutor training workshops prepare adult volunteers to help adult learners improve basic reading and writing skills, and/or conversational English skills (for foreignborn program applicants). It is not necessary for the tutor to know a foreign language. Upon completion of the workshop, tutors are expected to meet with their assigned students(s) for at least 2 hours a week, with a commitment to the program of at least one year. Tutoring takes place at a mutually convenient public building, usually the library. Tutors are also encouraged to attend at least one additional tutor support session each year. There is a $40 non-refundable registration fee for the workshop. This fee helps defray the cost of running the workshop. If you wish to receive future workshop schedules, complete and return a tutor application with no payment. This will place you on our mailing list to automatically be sent new workshop schedules and registration forms as they become available.

Be the difference in someone s life! Register now to become a Literacy Suffolk Volunteer Tutor Attendance at all four 3-hour sessions of the workshop is required. (12 hours) Tutor for at least 1 ½ - 2 hours a week and commit to our program for one year. Tutor at a public place, usually at a library. Work one-on-one with a student or in a small group of learners. Help an adult meet his/her goal! Workshop #361 ELL ONLY Huntington Public Library Station Branch 1335 New York Ave. Huntington, New York 11746 Saturdays 10 1pm October 22, 29, November 5, 19 Workshop #362 Suffolk Cooperative Library System- ELL & BLL 1 Suffolk Cooperative Library System SCLS 627 N. Sunrise Service Road, Bellport, NY 11713 Tuesdays & Thursdays 10:00am - 1:00pm January 17th, 19th, 24th, 26th 2017 Please print: Name Please indicate workshop choice by preference, Indicate workshop number. Address #1 #2 City, State, Zip Daytime Phone Signature Email address CALL LITERACY SUFFOLK 631-286-1649 to request an application 627 North Sunrise Service Road PO Box 9000 Bellport, NY 11713 631.286.1649 (O) 631.286.1668 (F) www.literacysuffolk.org

Literacy Suffolk, Inc. an accredited ProLiteracy affiliate Tutor Application Date: PLEASE PRINT CLEARLY Name Female Male Street City, State, Zip E-mail Address Best way to contact you: US Postal Mail Email DOB mm dd yyyy Phone: Work: Cell: The following information is needed for statistical purposes: Age: Ethnic Group: Education: Income Level: 16-20 White HS Diploma Less than $5,000 21-24 Black 12-14 years $5,000-$15,999 25-44 Hispanic 16 years $6,000-$25,999 45-59 Asian 16+ years $26,000-$41,000 60+ Am. Indian $Over $41,000 Other Public Assistance Not Available Employment: Occupation: Referred By: Full-time Professional Television Newspaper Part-time Managerial Radio Literacy Organization Unemployed Clerical Family/Friend Agency Disabled Technical Employer Poster Retired Service Library PR Talk Not in Market Agriculture Special Event Hotline Other (explain): Homemaker JUNIOR AMBASSADOR X Website Sales Student Have you ever been convicted of a crime? YES NO Employer Name: Job Title: Relevant Education Experience: Tutors and learners arrange to meet at a local library. Please indicate library & time preferences: Mornings (9am-11am) Daytime (12pm-4pm) Evenings (5pm-9pm) Weekends 1. 2. 3. This is a full year commitment of 1 ½ -2 hours weekly. If you are away for more than one month at a time, please consider other volunteer opportunities with Literacy Suffolk. Please see other side --------> 627 North Sunrise Service Road, PO Box 9000, Bellport, NY 11713 Phone: (631) 286.1649 Fax: (631) 286.1668 Website: www.literacysuffolk.org Rev.8/2015

Name: Please tell us below why you have chosen to become a Literacy Suffolk Tutor. Thank You!