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ELL Tutor Application

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ELL Tutor Application

Step 1 of 1

If you have questions about the ELL Program please contact Nancy Coleman-Romanos at 727-587-6715 ext. 2547 or ncoleman@largo.com

* Denotes a required field

Today's Date:

First Name:

Last Name:

Street Address:

City:

State:

ZIP Code:

-
Second portion of ZIP Code is optional.

Home Phone:

-- ext

Cellular Phone:

-- ext

Email:

What is the best way to contact you?

Home Phone

Cell Phone

Date of Birth:

Occupation/Profession:

Educational Background:

Degrees:

Please describe any past teaching and/or volunteer experience:

Have you had any formal training in teaching ESL?

Yes

If so, where, when and for how long?

Do you speak any languages other than English? If so, at what level of proficiency?

Travel, interests, hobbies:

Please describe your reasons for wanting to tutor an ESL student:

When can you begin tutoring?

Please check all the days and times that you are available for tutoring:

Mornings between 9 -12:

Mon

Tues

Weds

Thurs

Fri

Sat

None

Afternoons between 12-6:

Mon

Tues

Weds

Thurs

Fri

Sat

None

Evenings between 6-8:

Mon

Tues

Weds

None

Do you have any preferences concerning your student? (Age, Gender, Native Language)

Will you be using a laptop during your classes?

Yes

Not Sure

Can you commit to 2 hours of tutoring per week for six months?

Yes

I am interested in: (check all that apply)

One-to-one tutoring

Small group (2 to 4) tutoring

Conversation club facilitator

How did you find out about the ELL program? (check all that apply)

Family/friend

Library brochure

Website

Employer

Newspaper

Community agency

Additional Information

In case of emergency, please contact:

Emergency Contact Phone:

-- ext

Emergency Contact Address:

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