INSTRUCTIONS (please read):

Each month, tutors are required to turn in their tutoring hours for each student. These hours are inserted into the MAERS database, which is how the Literacy Council receives its funding, so it's important that we receive your logs.

The questions below are fairly self-explanatory. You can make ten separate entries on this form, which include date of session, number of instruction hours, and number of hours preparing for this session including driving time. There is also a place at the end of the form for additional pertinent information, which can include additional tutoring sessions if you meet more than ten times in one month.

All questions ending with an asterisk (*) need to be answered or the form will not submit properly. Once the form is completed, click on the "submit form" button below, and it will be forwarded directly to the Literacy Council.

Please call the Literacy Council if you need assistance filling in the form. Thank you for the part you play in helping to end illiteracy in Ionia County.

* Required fields

Name *

E-mail Address *

Student's name *

Reporting month * January February March April May June July August September October November December

Reporting year * 2009 2010 2011 2012 2013 2014

Tutor site (place where tutoring took place)

Date of 1st session *

Number of instructional hours at 1st session *

Number of hours spent preparing for 1st session *

Date of 2nd session

Number of instructional hours at 2nd session

Number of hours spent preparing for 2nd session

Date of 3rd session

Number of instructional hours at 3rd session

Number of hours spent preparing for 3rd session

Date of 4th session

Number of instructional hours at 4th session

Number of hours spent preparing for 4th session

Date of 5th session

Number of instructional hours at 5th session

Number of hours spent preparing for 5th session

Date of 6th session

Number of instructional hours at 6th session

Number of hours spent preparing for 6th session

Date of 7th session

Number of instructional hours at 7th session

Number of hours spent preparing for 7th session

Date of 8th session

Number of instructional hours at 8th session

Number of hours spent preparing for 8th session

Date of 9th session

Number of instructional hours at 9th session

Number of hours spent preparing for 9th session

Date of 10th session

Number of instructional hours at 10th session

Number of hours spent preparing for 10th session

Please check any of the boxes below that apply to your student for the month being reported. Type in month.

Improvement in self-confidence

Student’s skills are improving

Student got a library card

Workbook has been completed

Student obtained employment

Student’s employment improved

Student registered to vote

Student became a citizen

Student increased involvement in his/her children's education

Other achievement

If you checked "other achievement" above, please indicate what that achievement was.

If employment was obtained, please give the date employment began.

Please add additional comments here.

If you need tutoring materials, please indicate here what you need.

I have read and agree to the Privacy Policy *

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