Volunteer Registration

Step 1 of 2

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Are you a new volunteer or returning volunteer*
- I am a returning volunteer.
- No, I am a new volunteer.

First Name*
Last Name*
Address*
Street Address Unit/Apt. # City State / Province / Region ZIP / Postal Code
Phone*
Email*
Emergency Contact Name*
Emergency Contact Phone Number*
Availability*
- I will tutor a child on TUESDAY evenings at Pine Avenue Church in Chicago.
- I will tutor a child on THURSDAY evenings at First United Church of Oak Park.
- I will be a substitute tutor and will fill-in only on those nights when a tutor is absent.
- I would like to do volunteer work other than tutoring (Director will contact you to discuss).
My availability is*
- Tuesdays
- Thursdays
- Tuesdays & Thursdays
New Tutor
SKILLS / EXPERIENCE
What academic subjects are your strengths?*
- Reading
- Writing/Grammar
- Math (K-8)
- Advanced Math (9-12)
(Please check all that apply.)
Message
What is or was your primary occupation?:*
My student preference is:*
Choose Your Grade*
Returning Tutor
How many years have you been tutoring for Cluster Tutoring?*
Please enter a number from 1 to 100.
Message
STUDENT PREFERENCE*
- I would like to work with the SAME student as last year.
- I would like to work with a DIFFERENT student than last year.
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APPLICANT’S STATEMENT
I certify that I have made true, correct, and complete answers and statements on this volunteer application in the knowledge that they will be relied upon in determining my fitness to be a volunteer.

I acknowledge and accept the risks and liabilities involved with my participation in the Cluster Tutoring Program. I acknowledge that Cluster bears no responsibility or liability for volunteer-student contact or activities occurring outside of the Tuesday or Thursday evening tutoring sessions at Cluster sites and that any such outside contact or activities are not part of the tutoring program provided and administered by Cluster. I understand that volunteers are not to give students rides to or from tutoring, and I acknowledge that Cluster bears no responsibility or liability for any loss, damage or injury resulting from the unauthorized transportation of students.

I understand that Cluster may wish to photograph or film activities related to its tutoring program for promotional purposes and I authorize the use of my likeness for this purpose. If I do not wish to be photographed or filmed, it is my responsibility to notify the photographer or filmmaker and Cluster at the time such photography or filming is occurring.
Signature*
Date*

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Cluster Tutoring is a nonprofit, community-based organization that provides free one-to-one tutoring to more than 100 students primarily in the Austin neighborhood of Chicago’s West Side.

Contact Information

773-378-5530
clustertutoring@ clustertutoring.org
Cluster Tutoring
5460 W. Augusta Blvd.
Chicago, Illinois 60651

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New Tutor

SKILLS / EXPERIENCE

Returning Tutor

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APPLICANT’S STATEMENT

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Contact Information

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