Job Application

Academic Coaches Tutoring

Tutor Application

Contact Information

How did you hear about our Company? (Required):

*Tutor Name (Required):*
Address:
City, State & Zip:

*Home Phone (Required):*	Format = nnn-nnn-nnnn
Cell Phone:	Format = nnn-nnn-nnnn
Work Phone:	Format = nnn-nnn-nnnn
FAX:	Format = nnn-nnn-nnnn
DOB:	Format = mm/dd/yyyy

E-mail Address (Required):

Occupation/Profession Information

Current Occupation:
Current Employer:
Years Employed:
Looking for Full Time Employment?	Yes No

Education/Background Information

High School:
Degree from what College:
Post-Grad Degree College:
Other Areas of Study

Occupation/Profession Experience

List the areas/towns you would be willing to tutor in:

Distance/Driving time you are willing to travel from your home address:

Miles Minutes

Subjects/Grades You Are Comfortable Tutoring In

The following is not applicable to the Family Outreach Recruiter position and does not

need to be filled in.

Please indicate the grade levels you are willing to tutor:

Elementary School

Area of Specialization:

Middle School

Area of Specialization:

Study Skills	Basic Math	Pre-Algebra Math
English	Writing	Social Studies
Science	Other

High School

Area of Specialization:

Test Prep

Area of Specialization:

Foreign Languages

Area of Specialization:

List other Languages:

Computers

Area of Specialization:

Basic Home Computing: Internet, E-mail, MS Word, MS Excel, Etc.
Basic Networking	Adv. Networking	Other
Quicken/Quick Books

Special Education

Area of Specialization:

Do you have significant experience with Learning Disabled? Yes No
Please mark all that apply if "Yes" was selected above:
ADD	ADHD	Dyslexia
Autism	Other

List if "Other" checked above:

Other Skills and/or Training

Do you have any special skills or training that will aid in the development of our students? If yes, please explain below:

Availability/Schedule

School Year Availability (September - June)

Please indicate the days of of the week you desire to work as a tutor:

Saturday

Sunday

Hours Availability (September - June)

Please indicate the number of hours per week you desire to work as a tutor:

Summer Availability (July - August)

Please indicate the days of the week you desire to work as a tutor:

Saturday

Sunday

Hours Availability (July - August)

Please indicate the number of hours per week you desire to work as a tutor:

References

Professional and Personal References

Professional References and Telephone Numbers:

Name:	nnn-nnn-nnnn
Name:	nnn-nnn-nnnn
Name:	nnn-nnn-nnnn

Personal References and Telephone Numbers:

Name:	nnn-nnn-nnnn
Name:	nnn-nnn-nnnn
Name:	nnn-nnn-nnnn

Official Background Information

Have you ever been convicted of a misdemeanor or felony? Yes No

If "Yes", where and for what felonies and/or misdemeanors?

Will you submit to a drug test? Yes No

Will you submit to a background check? Yes No

Please include your Resumé below:

I certify that the information I have provided above is true, accurate and correct:

Signature (Required) Date Format = mm/dd/yyyy

To print and mail an application directly to the address below - CLICK HERE

	Academic Coaches Tutoring
	2440 Sandy Plains Road
	Building #2, Suite 210
	Marietta GA 30066
	Atlanta Metro: (678) 324-0960 Toll Free: (1-877) 378-7170
	Academiccoach@comcast.net

Are you currently a certified teacher?	Yes No	Years teaching
Have you ever worked as a private tutor?	Yes No	Years tutoring
Have you ever worked for a tutoring company?	Yes No	Years Working
Willing to tutor at a student's home?	Yes No
Willing to tutor at other locations?	Yes No
Willing to tutor student groups?	Yes No

Pre K	K	1	2	3
4	5	6	7	8
9	10	11	12	Adult

Study Skills	Reading	Reading Comprehension
Spelling	Writing	Phonics
Grammar	Math	Other

Basic Math	Algebra 1	Algebra 2
Adv. Algebra	Geometry	Pre-Calculus
Calculus	Trigonometry	Physics
Chemistry	Biology	Anatomy
Government	US History	World History
Economics	English Comp.	Eng./Grammar/Spelling
Study Skills	Reading Comp.	Organizational Skills
Creative Writing

PSAT	SAT I - Math	SAT I Verbal
SAT II	ACT	MCAS
SSAT	GED	General Test Prep

Spanish I	Spanish II	Spanish III
Spanish IV	French I	French II
French III	French IV	Italian
Portuguese	German	ESL (as 2nd language)
Latin	Chinese	Other (See below)