Literacy Volunteers of Clinton County

Contact Sheet
Tutor’s Name:		Phone:
Student’s Name:		Phone:
Please note any address or phone number changes for you or your learner:
CONTACT HOURS:
Tutor prep:	hours	Learner homework:	hours
Tutor travel:	hours	Learner travel:	hours
We met:	hours	Learner computer:	hours
STATUS OF MATCH
Continuing Discontinuing Never Met
Why:
Tutor will take new learner? Yes No
If yes, when available? Morning Afternoon Evening
Materials read:
Writing done:
Special activities:
Tutor Comments: (Any progress noted? Problems/Concerns?)
Do you need any assistance or handouts from the LVA office at this time?
GOALS/SPECIAL ACHIEVEMENTS (CHECK ALL THAT APPLY)
Entered employment Retained employment Improved employment Received GED Received secondary school diploma Placed in post secondary education Placed in training Did Not Enter Employment Did Not Retain Employment Did Not Improve Employment Did Not Receive GED Did Not Receive Secondary School Diploma Was Not Placed in Post Secondary Education Was Not Place in Training Obtained skills needed to pass US citizenship exam Removed from public assistance Had public assistance reduced Got involved in community activities Got involved in children’s education Got involved in children’s literacy activities Registered to vote or voted for the first time Improved basic skills for personal satisfaction Improved competency in government and law Improved competency in community resources Improved competency in consumer economics Improved competency in parenting Improved competency in occupational knowledge Improved competency in health care Learned or improved skills in using technology Other known outcome - Explain: Improved other competency - Explain:

Literacy Volunteers’ funding is based, in part, on the number of hours our records show. At the end of each month, please report your hours. THANK YOU!

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