Carver Center/ Coachman Family Center/ White Plains Youth Bureau
TUTOR APPLICATION FORM (Note: Please verify your FWS status with Financial Aid before applying)
Class: FR / SO / JR / SR Today’s Date: ________________
ID# ______________ FWS? YES / NO
Name: _____________________________________ Campus E-mail : [email protected]
Campus Ext: ___________ Cell Phone: _________________________Home: _________________________
Permanent Home Address: ______________________________________________________________
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Tutoring Experience:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Employment History: (List position and responsibilities, or attach resume)
___________________________________________________________________________
___________________________________________________________________________
References: (Two references: Name and phone number of former employer, teachers or professors)
TRANSPORTATION NEEDED?
U.S. DRIVER’S LICENSE?
SCHEDULE – Please select the position(s) you are applying for and circle the days of the week you are available to work for the entire semester
Coachman Tutor (Work hours: 3:15PM-5:45PM):
Carver Tutor (Work hours: 2:45PM-6:15PM):
Coachman Tutor/Driver (Work hours: 2:15PM-6:45PM):
WP Youth Bureau Tutor (Work hours: 9:30AM-3:30PM):
M T W Th F (At least 2 days a week) M T W Th F (At least 2 days a week) M T W Th F (At least 2 days a week) SATURDAYS (WPYB-Saturday Academy)
Revised: