Tutor Monthly Report - Pair Form

This report will be sent to the Clearfield Office.

Please submit your reports by the 10th of each month.
Thank you for your time and effort!

(click here for a printable version of the form)

Month / Year
   
Tutor's Name
 
Student's Name
 
Total Number of Hours
for this Month Only
 
instruction
prep
travel
Meeting Day / Time
   
Meeting Place
 
MSLC Supervisor
 
 Justine Kechison-Willett

1. Which goals are you working on this month?
2. List specific steps/activities taken to achieve the goal(s)?
3. What goals, if any, were reached?
4. What materials were used (texts and reading)?
5. Please choose which Learning Style is preferred by your student:
- Visual - Aural - Tactile
6. Give an example of part of your lesson that was
designed around your student's Learning Style:
7. List any successes that you have had this month
8. List any problems you have encountered this month:
9. Are you satisfied with the overall progress of your student?
10. Additional Comments:

  

Last Revised: 3/25/2009


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814-238-1809

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