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The Marshall University HELP Program

Community HELP Learning Specialist Application

Learning Specialist Application

Your Personal Information

Your Name

First Last

Your Email Address

Enter Email Confirm Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Phone

Are you a Citizen of the United States

Yes

If no, are you authorized to work in the US?

Yes

Have you ever been convicted of a felony?

Yes

If yes, explan:

Education

Education history(Required)

List the institution{s) you have attended, the dates you attended, date(s), degree(s) obtained, and your major(s) and minor(s).

Awards and Honors

List any academic awards or honors you've received

Previous Employment

May we contact your previous surpervisor(s)for a reference?(Required)

Yes

Your Previous Employers

Please list your previous employers, the dates you worked and the position you held

Comany

Supervisor name:

Supervisor email:

Supervisor phone

Start and End Dates

Reason for leaving

Your Previous Employers

Please list your previous employers, the dates you worked and the position you held

Comany

Supervisor name:

Supervisor email:

Supervisor phone

Start and End Dates

Reason for leaving

References

First Reference(Required)

Name

Address

Phone number

Relationship to Applicant

Second Reference(Required)

Name

Address

Phone number

Relationship to Applicant

Military Service

Experience

Branch

Dates Served

Rank at Discharge

Type of Discharge

If other than honorable, explain.

Questions for a potential Learning Specialist

What subject areas do you feel qualified to teach?(Required)

What experience have you had with students who have learning disabilities and/or ADHD?(Required)

Do you have any special or specific training in learning disabilities and/or ADHD?(Required)

What ages or grades are you most comfortable teaching/tutoring?(Required)

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