This is only a preview. No submissions will be saved, nor will emails be sent.
Thank you for your interest in volunteering. Please review the duties and qualifications for DCLC Volunteer Tutors here: https://delcoliteracy.org/volunteer and apply for a free PA State Criminal Background Check at https://epatch.state.pa.us. (Please copy and paste links.)
Fields marked with * are required.
*
$
Fields marked with * are required.
$
One Time
Recurring
Name
*
$
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Title
First Name
Last Name
$
One Time
Recurring
Email
*
$
$
One Time
Recurring
Address
*
$
Address Line 1
Address Line 2
City
State
Zip
$
One Time
Recurring
Phone
*
$
$
One Time
Recurring
PERSONAL INFORMATION
*
$
PERSONAL INFORMATION
$
One Time
Recurring
1. Gender
*
Female
Male
Transgender
Nonbinary
Gender nonconforming
Other
$
$
One Time
Recurring
2. Ethnicity
*
White/Other
Black
Hispanic
Asian
Pacific Islander
Native American
$
$
One Time
Recurring
3. Date of Birth
*
$
$
One Time
Recurring
4. Labor Status
*
Retired
Employed
Unemployed
$
$
One Time
Recurring
5. Occupation and Place of Employment
*
$
$
One Time
Recurring
6 Does your employer have a matching gift program?
*
Yes
No
$
$
One Time
Recurring
7 Have you had a felony or misdemeanor conviction?
*
Yes
No
$
$
One Time
Recurring
If you answered yes to Question 7 please explain
*
$
$
One Time
Recurring
8. How did you hear about us?
*
Banner
Library
Friend
Internet
Other (please describe below)
$
$
One Time
Recurring
Other response for Question 8
*
$
$
One Time
Recurring
If you answered "Other" for Question 8 (How did you hear about us?), please explain here.
EDUCATION
*
$
EDUCATION
$
One Time
Recurring
1. Highest Educational Degree You Earned
*
High School Diploma or equivalent
Associate Degree
Bachelor Degree
Master Degree
Doctorate Degree
Other (please describe below)
$
$
One Time
Recurring
NOTE: Once you complete Tutor Training, DCLC will need a copy of your college diploma or transcript to comply with PA Dept of Education guidelines.
Other response to Question 1
*
$
$
One Time
Recurring
2. Field of Study for your highest degree
*
$
$
One Time
Recurring
3. School where you earned your highest degree
*
$
$
One Time
Recurring
4 List any State Education Certifications you hold
*
$
$
One Time
Recurring
5. List any other Certifications you hold
*
$
$
One Time
Recurring
VOLUNTEERING INFORMATION
*
$
VOLUNTEERING INFORMATION
$
One Time
Recurring
1. When are you available to tutor?
*
$
Daytime
Evenings
$
One Time
Recurring
Choose ALL that apply
2. Where can you tutor? List 2 or more
*
$
Chester (area of great need)
Upper Darby (area of great need)
Other (please list below)
$
One Time
Recurring
Choose at least two locations (including the "Other" locations below) where you would be willing to tutor. Remember tutoring must occur in a public place, such as a local library.
2a. Other tutoring location for Question 2
*
$
$
One Time
Recurring
2b. Other tutoring location for Question 2
*
$
$
One Time
Recurring
2c. Other tutoring location for Question 2
*
$
$
One Time
Recurring
3. Details on your ability to tutor for 6 months
*
$
$
One Time
Recurring
Volunteer tutors are asked to commit to at least 6 months of tutoring, twice a week. Please describe anything that would prevent you from tutoring regularly in the next 6 to 12 months.
4. What interests you about volunteering?
*