Tutor's Name:           Tutor's Email: 

Student's Name:    

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

Hours this month: 0 .25 .5 .75 1 1.25 1.5 1.75 2 2.25 2.5 2.75 3 3.25 3.5 3.75 4 4.25 4.5 4.75 5 5.25 5.5 5.75 6 6.25 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.25 9.5 9.75 10 10.25 10.5 10.75 11 11.25 11.5 11.75 12 12.25 12.5 12.75 13 13.25 13.5 13.75 14 14.25 14.5 14.75 15 15.25 15.5 15.75 16 16.25 16.5 16.75 17 17.25 17.5 17.75 18 18.25 18.5 18.75 19 19.25 19.5 19.75 20                                         Prep Hours:  0 .25 .5 .75 1 1.25 1.5 1.75 2 2.25 2.5 2.75 3 3.25 3.5 3.75 4 4.25 4.5 4.75 5 5.25 5.5 5.75 6 6.25 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.25 9.5 9.75 10

Travel Hours    0 .25 .5 .75 1 1.25 1.5 1.75 2 2.25 2.5 2.75 3 3.25 3.5 3.75 4 4.25 4.5 4.75 5 5.25 5.5 5.75 6 6.25 6.5 6.75 7 7.25 7.5 7.75 8 8.25 8.5 8.75 9 9.25 9.5 9.75 10

Educational Goals: (tell us what your student is working toward):

Tell us about any progress your student has made to achieve these goals:

Any other accomplishments/successes:

Materials used this month (books, newspapers, etc.):

Any comments, questions, or concerns: