APPLICATION

Please fill out the application below. Barry Golden or Stephen Salz will contact you for an interview.

Last Name:

First Name:

Date:

Address:

Apt.:

City:

State:

Zip:

Home telephone:

Work telephone
(optional):

Mobile telephone
(optional):

E-mail:

Fax:

Title of Certificate License

Title of Certificate License

Title of Certificate License

Title of Certificate License

Please add any languages or subjects you may be proficient in:

Please check availability:

Before 3PM School Days
After 3PM School Days
Before & After 3PM

Other Times:

Where did you hear
about us?

The New York Times
Journal News
Newsday
Other

Please fill in any additional information that you wish.

Please fax or mail your resume, certificates, licenses, school letters or eligibility or any other pertinent information to:
Creative Tutoring, Inc.
1120 Old Country Road
Plainview, New York 11803

Fax: 516 822-0539

Or feel free to email creativetutor@optonline.net