First and Last Name *

Address *

City *

State *

Postal code *

Email *

Phone *

Best Time to Call *

Days & times available to serve: (check all that apply) *

Monday

Tuesday

Wednesday

Thursday

Friday

2:00 p.m.

3:00 p.m.

4:00 p.m.

5:00 p.m.

Where would you like to serve? (Check all that apply) *

Homework assistance

Read to students

Listen to students read to you

Teach a class

Math facts games

Assist teachers

Help wherever needed

Guest speaker

Grade level preference (Check all that apply) *

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

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