Tutor Form

Alternate Phone Number *

Address *

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City

State

Zip Code

Country

How did you find out about Kids at Heart? (church, friend, website, United Way, etc) *

Why are you interested in being a Kids at Heart tutor? *

What age groups and subjects are you most comfortable with? *

Community Involvement... *

Church Affiliation *

Universities/Colleges attended and degrees earned *

Personal Reference Name *

First

Last

Personal Reference Email *

Have you ever been accused of a crime? *

Yes No

If Yes, why and when? *

Do you promise not to smoke, drink alcohol, partake in drugs, or break the law while working with Kids at Heart? *

Yes No

As a KAH Tutor, I will be supportive, provide guidance, and serve as a positive role model for my Kids at Heart student. *

Yes No

Please choose your top three tutoring sites (we will do our best to accomodate) *

Mondays 3:00-4:30pm at First Presbyterian Church, 320 Date Street, San Diego, CA 92101 Mondays 2:45pm - 4:00pm at Washington Elementary, 1789 State Street Mondays 5:45-7:00pm at St. Paul's Cathedral, 2728 6th Avenue, San Diego, CA 92103 Tuesdays 5:30-6:30pm at Hacienda Learning Center, 350 17th Street, San Diego, CA 92101 Wednesdays 5:30-6:45pm at Bank of America, 655 W. Broadway, San Diego, CA 92101 Wednesdays 6:00-7:30pm at Iglesia Presbiteriana 2691 B Street, San Diego, CA 92102 Thursdays 3:30-4:45pm at Colina Park Rec Center, 5319 Orange Avenue, San Diego, CA 92105

I understand that once the Program Manager receives this Tutor Applicaiton, I will be contacted to schedule a meeting/orientation (to go over the program in more detail, answer any questions you may have, and decide on a tutoring site that works best) as well as receive information about where to get fingerprinted *

Yes No

Tutor Application - Kids at Heart tutoring