P.O. Box 5604
P.O. Box 5604
Flagstaff, AZ 86011-5604
928-523-2359
928-523-5991 fax
www.nau.edu/roadscholar
Questionnaire for Navajo Youth Education Service Program
Dear Tuba City Primary School Volunteer,
Please type in your answers
save document to your desktop
email it as an
attachment (or scan and send) to roadscholarprograms@nau.edu . Put ‘Tuba City
Primary’ and the program start date in the subject line (hold down Ctrl button on your
key board and click with your mouse if you have problems opening the link.).
OR
Fill it out online, print it out (saving it if you want) and mail it to: NAU Road Scholar
P.O. Box 5604 Flagstaff, AZ 86011 with your Health and Safety form in the envelope
provided.
.
Please don't hesitate to contact us if you need assistance or have questions, 928-5232359.
Week Attending:
The information below is important to the success of this tutoring program offered
through NAU Road Scholar Service Programs. Tuba City Primary School staff will use
this information to prepare in advance for this program. Thus, it is very important to
clearly indicate your subject(s) of interest
Remember that- your job and life experiences can be interesting to the students so
don’t limit yourself because you feel your job or life was not glamorous or fascinating. All
life experiences are important whether raising a family, or out in the working world, or
both. If you have information, DVD’s, CD’s, videos, photographs or any other materials,
please bring them with you. If you are a performing artist and wish to present a
performance, read stories or teach poetry, please let the coordinator know.
Name:
Address:
Phone:
Email:
Current/former vocation/profession:
1) Which subject(s) would you especially like to help students with? (reading,
music and arts, English or writing skills, math, science projects, sports, etc.). Be
as clear and specific as possible (this information may be used to place you with a
teacher):
2) Have you been a past participant in a Road Scholar Tutoring program? Where?
When?
3) Have you had experience working with children? In what context?
4) What are your hobbies and interests? Do you plan to bring supplemental
information with you, such as videos/slides, etc.?
5) What are your expectations of this program?
6) Have you visited the Navajo Reservation before?
7) What professional / life experience would you like to share with the students? If
you want to work in the classroom, would you like to give a short presentation in
your field of interest? If so, what would the subject be? Remember to gear it to
elementary students. This is optional and NOT a requirement of participation in
the program.
8) Please list here any special equipment you may need for a presentation: slide
projector, laptop and digital projector, etc. so that the school and coordinator may
prepare appropriately for your visit to the school.
9) Please write a short biographical sketch that we can share with the staff at the
schools.
Return completed questionnaires ASAP to NAU Road Scholar in the envelope
provided or send as an attachment via email to:
roadscholarprograms@nau.edu
(Hold down the Ctrl button on your key board and click with your mouse if you have
problems opening the link.)
If you have questions, please don't hesitate to contact NAU Road Scholar at 928523-2359.