Teacher Name School Grade Room # (For VIPS' use only) Phone: Home Phone Cell E-mail Subject Area Writing Reading Basic Math Science History Algebra I Algebra II Geometry Pre Calculus Biology Chemistry Physcis ESL Special education French Spanish Latin Italian Other Yes, I would like to welcome a college student, or community member, to work one-on-one or with a small group of children in my classroom on a weekly basis.Special Volunteer Requests (bilingual, ESL,Special Ed) Please Check All That Apply: I've had a VIPS' volunteer before and I would like this volunteer to return.Volunteer name I have contacted the volunteer. I am requesting a new volunteer. I need a volunteer for activities OTHER than tuturing, specifically I currently have VIPS' volunteers in my class. # of VIPS' volunteers Do you want your volunteer to work with: An Individual Student? Student Name Tutoring Subject Area Languages Spoken (Other than English): A Group?Number of Students Schedule of best days and times volunteer may work with students. Please specify time(not class period) and subject (i.e math, literacy,science). please select blocks of at least 1 hour. How many Tutors? Literacy Math Other (Please describe) TEACHER COMMITMENT: I understand that in requesting VIPS' services, I undertake a commitment to call my volunteer, complete VIPS' evaluations on my volunteer and report on my student(s)' progress. This means I will take time to set up the initial meeting with my volunteer, orienting him/her to my classroom and informing him/her of schedule changes. I Agree I Don't Agree