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Learner / Report for:
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Tutor's Name:
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Learner's Name:
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# of Meetings:
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Tutoring Time:
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Preparation Time:
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Travel Time:
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Is there anything your learner can do now - as a result of your tutoring - that was not possible before? Please check any areas that apply and briefly describe each of them. |
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Work |
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Improved job search skills so now able to look for a new job. |
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Got
a new job. |
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Has
improved skills or status at current job. |
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Other
work related achievements. |
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Health
and Food |
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Can
go shopping independently with
confidence. |
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Can
explain a medical problem to a
doctor or nurse. |
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Can
read
a menu at a restaurant. |
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Other
related achievements. |
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Education |
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Entered
a class or a training program. |
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Completed
a class or training program. |
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Is
more involved with children's
education. |
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Other
related achievements. |
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Community |
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Has
passed the citizenship test. |
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Can get around town independently better than before. |
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Is
more active in the community. |
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Other
related achievements. |
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Personal
and Money |
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Can
use the telephone with confidence. |
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Can
read newspapers and magazines. |
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Can
manage
money better than before. |
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Other
related achievements. |
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Status |
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Have you or your learner changed your phone number, email or mailing address? What is the new information. |
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Comments: |
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Please
click "Submit Your
Information" only once.
It will take approximately 30 seconds to
process your form. |