Welcome to the Monthly Reporting System! <br>
Please fill out this form as thoroughly as possible and remember to hit the "SUBMIT" button!
If you have any changes (in contact information, schedule or status of tutoring), please notify Literacy Services at 626-256-8272 or literacyservices@ci.monrovia.ca.us <br>

And, as always, thank you for your dedication to enriching a neighbor’s life!<br>


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<td><h3 style="border-bottom:1px solid black;">Monrovia Library Literacy Service's Monthly Report System</h3></td>
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<label for="tutorname" style="float:left;width:140px;">Tutor Name</label><input type="text" name="tutorname" id="tutorname" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="learnername" style="float:left;width:140px;">Learner Name</label><input type="text" name="learnername" id="learnername" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label style="float:left;width:140px;">Is your leaner a child?</label><span name="Yes" style="display:block;width: 400px;"><input type="checkbox" name="Yes1" id="Yes1checkboxOption" value="Yes" style="vertical-align: middle;border:0px;background-color:transparent"><label for="Yes1checkboxOption">Yes</label><input type="checkbox" name="Yes2" id="Yes2checkboxOption" value="No" style="vertical-align: middle;border:0px;background-color:transparent"><label for="Yes2checkboxOption">No</label></span><div style="clear:left;height:20px;"> </div>

<label for="tutoringsite" style="float:left;width:140px;">Tutoring Site</label><input type="text" name="tutoringsite" id="tutoringsite" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="monthandyear" style="float:left;width:140px;">Month and Year Reporting</label><input type="text" name="monthandyear" id="monthandyear" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="preptime" style="float:left;width:140px;">Total Hours Spent Preparing</label><input type="text" name="preptime" id="preptime" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="tutortime" style="float:left;width:140px;">Total Hours Spent Tutoring</label><input type="text" name="tutortime" id="tutortime" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="homeworkhours" style="float:left;width:140px;">Total Hours of Homework Given</label><input type="text" name="homeworkhours" id="homeworkhours" value="" maxlength="" style="width:200px;"><div style="clear:left;height:20px;"> </div>

<label for="materialsused" style="float:left;width:140px;">List of Materials Used</label><textarea name="materialsused" id="materialsused" style="width:200px;height:160px;"></textarea><div style="clear:left;height:20px;"> </div>

<label for="methodsused" style="float:left;width:140px;">Methods Used</label><textarea name="methodsused" id="methodsused" style="width:200px;height:160px;"></textarea><div style="clear:left;height:20px;"> </div>

<label style="float:left;width:140px;">Do You Have Any Requests for Materials?</label><span name="materialrequest" style="display:block;width: 400px;"><input type="checkbox" name="materialrequest1" id="materialrequest1checkboxOption" value="Yes" style="vertical-align: middle;border:0px;background-color:transparent"><label for="materialrequest1checkboxOption">Yes</label><input type="checkbox" name="materialrequest2" id="materialrequest2checkboxOption" value="No" style="vertical-align: middle;border:0px;background-color:transparent"><label for="materialrequest2checkboxOption">No</label></span><div style="clear:left;height:20px;"> </div>

<label for="materialinterest" style="float:left;width:140px;">If yes, then what materials are you interested in?</label><textarea name="materialinterest" id="materialinterest" style="width:200px;height:160px;"></textarea><div style="clear:left;height:20px;"> </div>

<label for="importantevents" style="float:left;width:140px;">Recent Important Literacy-Related Events in Your Learner's Life</label><textarea name="importantevents" id="importantevents" style="width:200px;height:160px;"></textarea><div style="clear:left;height:20px;"> </div>

<label style="float:left;width:140px;">Did you have any difficulties or problems this month?</label><span name="difficulites" style="display:block;width: 400px;"><input type="checkbox" name="difficulites1" id="difficulites1checkboxOption" value="Yes" style="vertical-align: middle;border:0px;background-color:transparent"><label for="difficulites1checkboxOption">Yes</label><input type="checkbox" name="difficulites2" id="difficulites2checkboxOption" value="No" style="vertical-align: middle;border:0px;background-color:transparent"><label for="difficulites2checkboxOption">No</label></span><div style="clear:left;height:20px;"> </div>

<label style="float:left;width:140px;">Would you like the Literacy Coordinator to call you?</label><span name="contactus" style="display:block;width: 400px;"><input type="checkbox" name="contactus1" id="contactus1checkboxOption" value="Yes" style="vertical-align: middle;border:0px;background-color:transparent"><label for="contactus1checkboxOption">Yes</label><input type="checkbox" name="contactus2" id="contactus2checkboxOption" value="No" style="vertical-align: middle;border:0px;background-color:transparent"><label for="contactus2checkboxOption">No</label></span><div style="clear:left;height:20px;"> </div>

<label for="commentsandconcerns" style="float:left;width:140px;">Comments and Concerns</label><textarea name="commentsandconcerns" id="commentsandconcerns" style="width:200px;height:160px;"></textarea><div style="clear:left;height:20px;"> </div>

<label style="float:left;width:140px;" for="easeofuse">Please rate how easy or hard it was to use this form</label><select name="easeofuse" id="easeofuse"><option value="veasy">Very Easy</option><option value="seasy">Somewhat Easy</option><option value="soso">So-So</option><option value="shard">Somewhat Hard</option><option value="vhard">Very Hard</option></select><div style="clear:left;height:20px;"> </div>

<label for="thankyou" style="display:none;">hidden field</label><input type="hidden" name="thankyou" id="thankyou" value="http://monrovialiteracy.wordpress.com"><div style="clear:left;height:20px;display:none;"> </div>


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