CASP

1023 N. FLOOD AVENUE

NORMAN, OK 73069

APPLICANT INFORMATION

First Name *

Middle Name

Last Name *

Local Street Address *

City *

Zip Code *

Permanent Mailing Address *

City *

State *

Zip Code *

Cell Number *

Alternate Phone

Date of Birth *

Social Security Number *

Email Address *

Emergency Contact *

Emergency Contact Phone *

What is your preferred method of contact? *

Text

Call

Do you have a high school diploma, General Education Development (GED) credential, or equivalent? *

Yes

If no, please list your current classification, e.g. freshman, sophomore, etc.

Are you currently attending college? *

Yes

If yes, please list your current classification, e.g. freshman, sophomore, etc.

How did you hear about this volunteer opportunity?

SCHEDULE

Tutors must have the ability to commit to a set weekly schedule and a minimum of one semester.

Please list the days and hours you are available to work between 3:00 pm - 6:00 pm. Monday - Friday. *

GENERAL QUESTIONS

Please tell us why you would like to tutor with CASP. *

Do you have previous tutoring experience? *

Yes

If yes, please describe.

Do you have previous experience working with children? *

Yes

If yes, please describe.

Do you fluently speak any languages besides English? *

Yes

If yes, please list.

PERSONAL REFERENCES

Reference (1) First Name *

Reference (1) Last Name *

Reference (1) Relationship *

Reference (1) Mailing Address *

Reference (1) City *

Reference (1) State *

Reference (1) Zip *

Reference (1) Phone *

Reference (1) Email *

Reference (2) First Name *

Reference (2) Last Name *

Reference (2) Relationship *

Reference (2) Mailing Address *

Reference (2) City *

Reference (2) State *

Reference (2) Zip *

Reference (2) Phone *

Reference (2) Email *

Reference (3) First Name

Reference (3) Last Name

Reference (3) Relationship

Reference (3) Mailing Address

Reference (3) City

Reference (3) State

Reference (3) Zip

Reference (3) Phone

Reference (3) Email

DISCLAIMER & SIGNATURE

I hereby certify the information provided on this form is true and complete to the best of my knowledge. I also authorize a complete background check, including verification of education and employment, reference check, and criminal background check, if needed, for the position for which I'm applying. *

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