Have you volunteered before? Yes No Are you able to volunteer between 2-4 hours per week for at least 6 months? What is your age range (some learners prefer to work with tutors of similar age)? 19 - 25 26 - 35 36 - 45 46 - 55 56- 65 66 -75 76 and over Are you willing to submit to a criminal reference check? Yes No 1. What factors do you believe have contributed to this high rate of illiteracy? 2. Why do you want to teach other adults? 3. What do you feel are the two most important qualities you have to offer to an adult learning to read? 4. Please describe any teaching experience you have had (teaching something to an individual or group). Additional Information Do you have any other comments, questions or concerns?