Literacy Volunteers Charlottesville/Albemarle |

Due to the pandemic, new tutor training in on hold. However, we hope to have a new, online training ready to roll out in early fall. By completing this form, you will be added to the list to be contacted once that training is open. Please contact Steven Reid (sreid@literacyforall.org) with any questions.

Name

Date of Birth

Gender MaleFemaleOther

Street Address

City

State

Zip

Preferred Phone

Native Language

Other Language(s)

Family Information
(Used when completing a match.)

Martial Status MarriedNot Married

Number of Children

Field of Study

Occcupation

Professional certificates or licenses held

Employer

Have you ever been convicted of a crime? YesNo

If yes, please explain.

LVCA will not deny voluntee rpositions to any applicant solely because the person has been convicted of a crime. However, you should be prepared to discuss during placement interview.

Do you have any health conditions/issues that would impact your participation?

Learner Preference MaleFemaleEither

Location Preference

Program Preference

Check all that apply.

Basic LiteracyEnglish as a second languageHigh School equivalencyMath

Other Volunteer Interests Administrative/Office HelpBoard of Directors/Committee WorkFundraising

Availability

Please add the days of the week and times you are available. Use one row for each day of the week.

Day	Morning	Afternoon	Evening

Why do you want to be a literacy volunteer?

Notes or other information we should consider before matching you with a student:

By signing this application, I hereby affirm that the information provided on this form is true and complete. I understand that the information is subject to verfication. I understand that false or misleading information may result in dismissal.

LVCA VOlunteer Intake Form