Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
Interests & Activities
Please list your extracurricular interests and activities outside of the academic setting (ex: sports, art, music, STEM, baking, etc.)
If these items are also referenced in your resume, feel free to write "see resume" below.
Skills & Talents
Briefly describe any special skills, talents, or competencies you demonstrate (ex: languages spoken, areas of expertise, interesting talents, etc.)
If these items are also referenced in your resume, feel free to write "see resume" below.
Experience Working with Children
Please describe any experience you have working with children and/or teens (ex: tutoring, babysitting, music lessons, sports coaching, camp counseling, etc.)
If these items are also referenced in your resume, feel free to write "see resume" below.
Weekly Availability - Monday
Please select all times that you are available to work with a student each week. All times are listed as ET.
8 AM-10 AM
10 AM-12 PM
12 PM-2 PM
2 PM-4 PM
4 PM-6 PM
6 PM-8 PM
Weekly Availability - Tuesday
Please select all times that you are available to work with a student each week. All times are listed as ET.
8 AM-10 AM
10 AM-12 PM
12 PM-2 PM
2 PM-4 PM
4 PM-6 PM
6 PM-8 PM
Weekly Availability - Wednesday
Please select all times that you are available to work with a student each week. All times are listed as ET.
8 AM-10 AM
10 AM-12 PM
12 PM-2 PM
2 PM-4 PM
4 PM-6 PM
6 PM-8 PM
Weekly Availability - Thursday
Please select all times that you are available to work with a student each week. All times are listed as ET.
8 AM-10 AM
10 AM-12 PM
12 PM-2 PM
2 PM-4 PM
4 PM-6 PM
6 PM-8 PM
Weekly Availability - Friday
Please select all times that you are available to work with a student each week. All times are listed as ET.
8 AM-10 AM
10 AM-12 PM
12 PM-2 PM
2 PM-4 PM
4 PM-6 PM
6 PM-8 PM
Background Check Disclosure
If there is anything you would like to disclose or elaborate on that may show up on a background check, please do so here. Alternatively, you may email an explanation to champions@wec.education
Reference 1 Name
*
First Name
Last Name
Reference 1 Email
Reference 1 Phone
Reference 2 Name (Optional)
First Name
Last Name
Reference 2 Email (Optional)
Reference 2 Phone (Optional)
(###)
###
####