Tutor Name:

Reporting Month:
January February March April May June July August September October November December

Year:
2013

Student Name:

Number of times met this month:

Number of Instructional Hours this Month:

Number of Lesson Preparation Hours:

Number of Driving Hours:

Number of In-Service Hours:

Other Hours (i.e. committees, waiting for student, board meetings, etc.):

Materials used this Month:

Title of any completed workbook(s):

Tutor Comments or Requests:

Student information that should be updated:  Help/More Info

My Student and I worked on the following (Check all that apply):
Reading
Writing
Phonics
Pronunciation
Listening Skills
Math Skills (describe below)
Citizenship
Science
Social Studies
Literature or GED Reading
Reading skills for a job
Other

Describe Math or Other skills here: