Ruth G. Hardman Adult Literacy Service
Tutor Registration

Computer Lab | Family Literacy | Learning Difficulties | Literacy Links
Literacy Office Resources| Training Schedule | Tutor Registration

Register for a workshop by submitting the following information.

Title:  Mr.  Mrs.  Ms.  Miss

Name: 

Mailing Address: 

City: 

Zip Code: 

Telephone

Home: 

Work: 

Email: 

How did you hear about our program?

Which workshop would you like to attend? (Training Schedule)  

1st Choice: 

2nd Choice: 

Do you have any children living at home?  Yes  No

In what part of Tulsa (or surround area) do you live?  (For example, southwest, east, northeast)? 

Gender:  Male  Female

Date of Birth:  / /   mm/dd/yyyy

Ethnicity: 

Please choose the highest educational level completed: 

Employment Status: 

Occupation:  (If retired or currently not in the job market, please indicate professional background.)

Employer: 

What days are you available to tutor?

Monday  Tuesday  Wednesday  Thursday  Friday  Saturday  Sunday

What time of day are you available to tutor?

Morning      Afternoon     Evening

At what libraries are you willing to meet?

Central

Broken Arrow

Brookside

Bixby

Charles Page

Collinsville

Hardesty Regional

Helmerich

Glenpool

Jenks

Kendall-Whittier

Martin Regional

Maxwell Park

Nathan Hale

Owasso

Pratt

Rudisill Regional

Suburban Acres

South Broken Arrow

Schusterman-
Benson

Skiatook

Sperry

West Regional

Which would you prefer?  Beginning Reader  More Advanced Reader

Comments: 

Would you like to work with a special needs student?  Yes  No

If yes, which special needs student would you prefer?

English as a second language     Developmentally Disabled

Adjudicated Juvenile/Adult          Physically Handicapped

What are your special interests (e.g. fishing) or skills (e.g. sign language)?

Have you tutored in an adult literacy program before?  Yes   No

Explain what you hope to achieve as a tutor in the Library's Adult Literacy program.

Have you worked with children before?  Yes   No

If yes, in what capacity? 

Are you involved in other volunteer activities?  Yes    No

If so, please list those organizations: 

Are you a Tulsa Community College student taking this course for credit?  
Yes  No

Once you have completed the form, place a checkmark in the box below and then click on the submit button.  If you would like to erase the form and start over, click on the reset button below.

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