Name  

RU ID#  

Home Address  

Campus P.O. Box  

Major      Class Of      College  

E-Mail Address  

Can you work: Hours between 9:00 - 3:15 (In-school program)?   yes no      

Hours between 3:15 - 6:00 (After-school program)? yes no

Can you commit to 8-12 hours per week during the school year?  yes no

Which program(s) are you interested in? Please rank in order of preference.

Have you spoken to anyone about the America Reads*America Counts Program?  yes no

If yes, who?  

Please tell us about your prior experience working with young children.  Please include paid and volunteer positions.  If you have no direct experience working with children, describe your interest in working with children.