Tutors: Please fill in the information below and click the submit button at the bottom.
Tutor’s Name
Tutor’s Email
Student's Name
Basic
ESL
Location of Class
Day & Time of Class

Month/Year	Total Tutoring Time

Please check off which goals, if any, your student has accomplished this month. Use blank spaces for additional goals.
LITERACY		SURVIVAL		EDUCATION		COMMUNITY		EMPLOYMENT		PARENTING
Improved ability to speak English		Banking/ Finances		Attended Adult Ed Classes		Involved in Community activity/ volunteering		Learned job search skills		Read to child
Improved ability to understand English		Shopping		Attended College		Voted		Applied for job		Helped child with homework
Improved ability to read		Telephone use		Studied for GED exam		Learned about USA		Obtained job		Attended PTA meeting
Improved ability to write		Medical care		Passed GED		Applied for US citizenship		Entered job training program		Attended school conference/ meeting
Read for pleasure		Obtained Driver’s License		Studied on-line		Received US citizenship		Improved job performance		Volunteered at school
Wrote letter/note		Improved computer skills		TOEFL exam		blank		Passed Licensing Exam		Visited library with child
Read newspaper or magazine		Used a community resource		blank		blank		Received job advancement		Understood written materials from school
Applied for library card		Gave/followed directions		blank		blank		Received Commendation or praise		blank	blank
Used library		Increased confidence		blank		blank		blank		blank	blank
Improved grammar		Greater Independence		blank	blank	blank	blank	blank	blank	blank	blank

Please let us know any other goals your student has accomplished this month:

Comments:

Remember we are here to help you, so please call us if you have any questions, need tutoring materials or are no longer meeting with your students.