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One-on-One Tutor Report

Please fill out the One-on-One Monthly Tutor Report Form and submit.

Student*:
Tutor*:
Meeting Place*:
Vita Contact Person:
Report Period: (mo/yr)
Number of Hours this Month: tutoring preparation
Change in Phone or Address?  Student Tutor
New information:

Learning Activities

 Listening Speaking Reading Writing Pronunciation
 Vocabulary Structure Culture Phonics Math

Other Learning Activities:

Is Your Student Making Progress? Yes No

Achievements: (such as new sight words, new book level, used a map, wrote a letter)

Materials Used:

Source of Materials:

 VITA Library Public Library Tutor-made Other

Match Discontinued? (Date)

Reason:

Additional Comments:

What I Need: