Read. Learn. Grow.


Quarterly Report Form

Please report the hours you spent tutoring one-to-one, small group, or in a classroom. Also report any non-tutoring hours such as Literacy Volunteers of Lake County Board activities. Additionally, please report any time spent in observing instruction. For example, count the time you might spend observing the instructor in an Adult Education classroom. If you are tutoring more than one adult learner, please list separately the name and the hours of instruction for each learner. If you stopped tutoring this quarter, please indicate the date on which you last tutored and your accumulated hours.

This information is vital...we are required by the state to file reports on volunteer tutoring activities to assure continued grant funding! This report is due by the 5th of the month after the quarter ends, so PLEASE BE PROMPT with your reply. Thanks for your commitment to your students and the program.

Your Name
Tutoring hours:
Non-tutoring hours:
Classroom or small group hours:
Classroom observation hours:
Individual hours:
 First Name: Hours:
First Name: Hours:
First Name: Hours:
No longer tutoring:
(Date tutoring stopped; what happened to student?)
Your eMail
    If you include your email, you will receive a copy.
Quarter:
1st (July, Aug, Sept) 2nd (Oct, Nov, Dec)
3rd (Jan, Feb, March) 4th (April, May, June)

The Quarterly Report form can be mailed or faxed to:

Onice Pitts, Literacy Secretary
College of Lake County - Building #4
19351 W. Washington St. Grayslake, IL 60030-1198
Telephone 847 543-2024 / Fax 847 223-7580
www.adultlearningconnection.org

Onice Pitts, Records Manager: opitts@clcillinois.edu



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