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 Boarding School Volunteer,
Please type in your answers
save document to your desktop
email it as an
attachment (or scan and send) to Principal, Medge Windmiller at
medge@frontiernet.net (If you have problems opening the link, hold Ctrl button on
your key board and click with your mouse). Put Road Scholar, ‘Tuba City
Boarding School’ and the program start date in the subject line
OR
Fill it out online, print it out (saving it if you want) and mail it to:
Medge Windmiller, Principal
Tuba City Boarding School
Box 187
Tuba City, AZ 86045
Note: Health and Safety Form is returned to NAU Road Scholar separately.
Please don't hesitate to contact us if you need assistance or have questions, 928523-2359.
Week Attending:
The information below is important to the success of this tutoring program
offered through NAU Road Scholar Service Programs. Tuba City Boarding 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 questionnaire to:
Medge Windmiller, Principal
Tuba City Boarding School
Box 187
Tuba City, AZ 86045
OR via e-mail: medge@frontiernet.net (928) 283-2337
(reference Tuba City Boarding School Questionnaire and date in subject line)
Note: Health and Safety Form is returned to NAU Road Scholar separately.
(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 928-5232359.