Tutor Application (copy - August 17, 2010)

Thanks for your interest in our company. Please fill out the form as completely as possible. If we think your qualifications match an open position, we will contact you.

Please note: All engagements with our company are on an independent contractor (1099) basis.

1. Contact Information

First Name *This question is required.

Last Name *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

Zip Code *This question is required.

Email Address *This question is required.

Mobile Phone *This question is required.

2. What is the highest level of education you have completed?

3. List any degrees or certificates you have.

Space Cell	Year	School	Degree & Major
1. *This question is required	Year	School	Degree & Major
2.	Year	School	Degree & Major
3.	Year	School	Degree & Major

4. Why do you feel qualified for this position?

5. Are you certified? *This question is required.

Please enter an 'other' value for this selection.

6. You understand we only offer Part-Time assignments? *This question is required.

Tutoring experience and qualifications

7. Formal tutoring experience

Space Cell	Where	Length of time	Subjects tutored	# Students
#1	Where	Length of time	Subjects tutored	# Students
#2	Where	Length of time	Subjects tutored	# Students
#3	Where	Length of time	Subjects tutored	# Students
#4	Where	Length of time	Subjects tutored	# Students

8. Grade levels qualified to tutor:

9. English:

Elementary level
Writing
Reading Comprehension
Essay Composition

10. Math

11. Sciences

12. Social Sciences

US History
World History
Economics
Geography

13. Foreign Languages:

Space Cell	Level I	Level II	Level III+
Spanish	Level I	Level II	Level III+
French	Level I	Level II	Level III+

14. Test Prep:

Logistics and Communications

15. Locations you can tutor in - YOU MUST LIVE WITHIN 15 MILES from the city:
(Check all that apply) *This question is required.

16. How long are you planning to tutor? *This question is required.

17. When can you start? *This question is required.

Please enter an 'other' value for this selection.

18. Your Availability:

Space Cell	Mon	Tue	Wed	Thu	Fri	Sat	Sun
From-To:	Mon	Tue	Wed	Thu	Fri	Sat	Sun

19. Are you willing to under go a background check? *This question is required.

Resume and References

20. Please provide Four (2) references:
(Must be Tutoring related. We will only contact them with your permission) *This question is required.

Space Cell	Name	Phone #	Email	Tutoring provided
1. *This question is required	Name	Phone #	Email	Tutoring provided
2.	Name	Phone #	Email	Tutoring provided

Once you click on the 'Submit' button below, you will receive an email from us requesting your Resume. Please reply to our email and attach your Word resume to it. If you do not see our email in your inbox please check your SPAM folder.

Please also ensure our email address is added to your SAFE senders list so that our emails do not go to your SPAM folder in the future.

Thank you,

ClubZ! Tutoring of OC

Tutor Application (copy - August 17, 2010)

Page One

Tutoring experience and qualifications

Logistics and Communications

Resume and References