Friendship Tutoring Program

Tutor Application

Fall 2007/Spring 2008

Please complete the following questions and email your application to: lpgriffin@verizon.net

Name:

Best Phone #:

Email Address:

Major:

Semester Standing:

Do you have the following clearances? You will need to provide a copy if accepted into the program.

*Pennsylvania Child Abuse History Clearance Yes No

*Criminal Record Check Yes No_

Note: Both forms can be accessed by going online to:

http://www.dpw.state.pa.us/General/FormsPub/003671038.htm Do not mail your clearance applications to Friendship Tutoring. There is a $10 fee for each.

Please list any experience you have had with children:

Why you are interested in giving time to the program and what do you hope to gain from this experience?

(Feel free to add another page if needed)