Information on this form is used for reports to our funding sources and for program development.
We do not share your personal identifying information.
*Answering YES will not necessarily disqualify you from our program. If you answered YES, please list the date(s) of the conviction(s), the city and state, and the offense(s).
I understand that a criminal background check will be performed by the Literacy Council of Sheboygan County before I am accepted as a volunteer. I authorize any institution, information agency, or law enforcement agency to furnish any and all related information.
Any information received as a result of a background check is kept strictly confidential.
Tutors and students meet at their local public library or another public location.
When will you be available? Check all that apply