ColumbusReads : Registration Form

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Registration Form 2007-2008

The Ohio State University ColumbusReads Program Tutor/Substitute Information
Name:	(Required)
Title:
Dept:
Building & Room:
Street Address:
What hours do you work:
Please indicate your tutoring preference.	Tuesday Permanent Tutor , 9:00 a.m. - 11:00 a.m. weekly (several tutors needed )
	Tuesday Substitute Tutor : Called to tutor in the event that a permanent tutor cannot attend.
	Thursday Permanent Tutor , 9:00 a.m. - 11:00 a.m. weekly (very few tutors needed )
	Thursday Substitute Tutor : Called to tutor in the event that a permanent tutor cannot attend.
Preferred Dates:	All Year: October 2, 2007 - May 8, 2008
	Fall Quarter: October 2, 2007 - December 14, 2007
	Winter Quarter: January 14, 2008 - March 21, 2008
	Spring Quarter: March 31, 2008 - May 8, 2008
Affiliation:	A & P
	Faculty
	CCS
	Undergraduate Student
	Graduate Student
Work phone:
Home phone:
Fax Number:
E-mail Address:	(Required)
Supervisor's Name:	(If Appropriate) For tutors using work hours to tutor, be sure that the above listed supervisor is aware of and has approved your participation in the ColumbusReads program during work hours.
Supervisor's Title:
Supervisor's Work phone:
Supervisor's Email Address:

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