Name                                                                                                                                    

Address                                                                                                                                

City                                                                                             ZIP                                    

Home Phone                                         Cell Phone                           E-mail                      

Social Security Number                                                                     (Teachers/Subs only)

Employer                                                                                                       

Work Number                                                           

 

Do you hold a Teaching Certificate?     YES              NO            

State                 Exp. date                    Endorsements                                                        

 

Subjects (Please highlight, bold or list those you feel comfortable to tutor):

            Elementary:  PK   K  1  2  3  4  5    Subjects:                                                      

            Middle:            6  7  8    Subjects:                                                                           

            Math:  Algebra 1       Algebra 2       Geometry       Trigonometry  Math Analysis

                         Calculus        Prob. & Stat.                                                                         

            Science:  Biology         Chemistry   Physics          Earth Science                       

            English                                                                                                                     

Business:     Accounting        Statistics                                                                

            Languages & levels:                                                                                            

            Reading: methods/experience                                                                             

            Social Studies: Geography                                                                                  

 

Study/organizational skills:                                                                               

            SAT/ACT Prep:       Math                  English                        
            (Please list your scores if interested in tutoring the SAT: math         English            )

Other Preps:            PRAXIS         GRE               GED               ASVAB         

 

Computers:  Operating Systems                                                                         

                                    Programming                                                                       

Special needs students (list):                                                                            

 

Music Lessons:                                                                                                     

           

Preferred days and times:

            Mon.                  Tues.              Wed.               Thurs.                        Fri.

                                                                                                                                     

            Sat.                    Sun.

                                                           

 

Preferred Areas (please highlight/list those cities/areas where you are willing to tutor):

            Virginia Beach                                                                                                   
          Chesapeake:  Great Bridge              Hickory           Deep Creek              Western Br. 

Norfolk            Portsmouth                Suffolk            Isle of Wight    Hampton
            Newport News            Poquoson                  Williamsburg

 

Teaching Experience:

Name of school                  School System       Grade/subjects                   Dates

           

Education:

College/Univ.                                               Dates                                     Major         Degree

 

References (Please list three):

Name                                     Position                    Address                                Phone

           

Personal Information:

Have you ever been discharged or refused contract renewal?                         
                                            

I hereby authorize Achievement Plus to conduct work history, personal reference, and police record inquiries to determine my acceptability for tutoring.  Further, I hereby authorize and direct any and all federal, state, or local agencies or offices that may possess information to cooperate and assist Achievement Plus in its investigation.

 

I certify that the information in this application is true and correct.

                                                                                                                                                                               Signature                                                                              Date