Poverty Services
Catholic Charities of Southern Illinois
Catholic Diocese of Belleville
Diocesan Pastoral Center
2620 Lebanon Ave.
Belleville, IL 62221

Phone Janet at (618)526-7203 Fax (618)526-2974


Volunteer No.
 
Application For Tutoring (Volunteer)
Last Name First Name Middle Name
     
Address Age Sex
     
City State Zip Code County
  IL    
Parish/Church Home Phone Work Phone
     

Please indicate the areas you are interested in assisting
GED Studies  
Reading  
Math  
Budgeting  
Basic Life Skills  
Please explain any special requirements or circumstances that should be considered
 
 
 
 
 
 
 
 
Signature Date