2021-2022 TUTOR APPLICATION
Complete this form in order to become a Tutor for home bound students.  NOTE:  1. You must be a current Boston Teacher's Union Member /Boston Public Schools employee.  2. If you are not in a teaching position, you must be referred by your headmaster/principal to only work with students from his/her school.  We will send your principal/headmaster a separate form to complete referring you to Home and Hospital Instruction.  3. All tutors will tutor on as needed basis at no more than 16 hours per week and no more than 2 students at a time. For additional inquiries, contact 617-635-6633 or e-mail sholland2@bostonpublicschools.org or homeandhospital@bostonpublicschools.org.

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First Name: *
E-mail *
Street Address: *
City: *
Zip Code: *
Employee ID Number: *
Cell Number: *
Home Number:   *
Position you currently hold: *
Required
If Other, name the position.
Name of the school where you currently work: *
Certification: *
Current Duties: *
Bilingual Language Spoken: *
Principal/Headmaster Name: *
Emergency Contact Name: *
Emergency Contact Phone Number: *
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