Literacy Tutor Hours
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Literacy Tutor Hours Sheet

Literacy Tutors use this form to submit your hours volunteered.

1. Your Name

Your Name First Name
Last Name

2. In which county do you tutor?

In which county do you tutor? Cleveland

McClain

Pottawatomie

3. Name of Student(s) Tutoring:

Name of Student(s) Tutoring: Student 1:
Student 2:
Student 3:
Student 4

4. Month Tutoring

Month Tutoring

5. Number of Hours for Month

Number of Hours for Month

6. Have a change in how we should contact you? Let us know!

Have a change in how we should contact you? Let us know! Phone Number
Email
Mailing Address

7. Additional comments you would like to share with the PLS Literacy Program?

Additional comments you would like to share with the PLS Literacy Program?