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Tutor Report Form
Monthly Tutor Report Form
thank you for volunteering
Reports are due at the end of each month.  Thank you!
Date Report is being Submitted
MM/DD/YYYY
First / Last  Name                                                         First / Last Name
Tutor:
Student:
Contact number or email:
Select One
Progress Report:
Using lessons pertaining to student’s job?
Select One
What Successes/Improvements Have You Noticed? (check all that apply)
If your student has discontinued tutoring, please select the relevant item:
Select One
If you have discontinued tutoring, please select the relevant reason:
Select One
Is there anything we can help you with? More to share? Enter comments in the Box on the Right. Thank You!
Month 
Hours Preparing
Hours Tutoring
HoursTraveling 
We keep track of all the hours you donate!  Please enter the hours you spent this month tutoring, preparing, and traveling to tutoring sessions.
Literacy Council of Alaska
517 Gaffney RoadFairbanks, Alaska  99701T: 907-456-6212F: 907-456-4302lca@literacycouncilofalaska.org
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If selected Other, please specify:
If selected Other, please specify:
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Improved reading skills
Improved writing skills
Improved English speaking skills
Improved math literacy skills
Improved computer literacy skills
Built citizenship skills
More involved in children’s schooling
More involved in children’s literacy
Received driver’s license
Obtained a new job
Retained job
Improved current job
Obtained diploma or GED
Entered job training/educational program
Registered to vote/voted
Got off public assistance
Moved out of public housing
Received passing score on TOEFL
Other