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America Reads Application
America Reads Application
Fill out this application to become an America Reads and/or America Counts tutor. You will also need to get a
Child Abuse History Clearance and a Criminal Record Check
.
1.
*
First Name
2.
*
Last Name
3.
*
Student ID# or Social Security Number:
4.
*
Phone number
5.
*
Drexel E-mail Address
6.
*
Are you interested in America Reads or America Counts?
America Reads
America Counts
Both
7.
College/School
8.
*
Local Address:
9.
Are you interested in America Reads/Counts as a volunteer or work-study?
Volunteer
Work-study
10.
Birth date:
(mm/dd/yy)
11.
Program of study
12.
You understand that you must get two clearances: a Child Abuse History Clearance and a Police Record Check. These forms both require $10 money orders. This money will be reimbursed when you begin tutoring.
Criminal Record Check
I understand
13.
*
How many hours would you like to tutor per week?
Fewer than 2
2 - 5
6 - 10
11 - 15
16 - 20
More than 20
*
denotes a required field
Modified:
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