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ABOUT
PROGRAMS & SERVICES
- Older Adults
- Children & Families
GET INVOLVED
Events
RESOURCES
CONTACT

ABOUT
PROGRAMS & SERVICES
- Older Adults
- Children & Families
GET INVOLVED
Events
RESOURCES
CONTACT

Student Application

First Name

Last Name

Date of Birth

Street Address

City

State

Zip

Phone Number

Email Address

Gender

Marital Status

Do You Have Children At Home?

If Yes, How Many?

Total Number of Household Members

Housing Status

Native Language

Country of Birth

Do you read/speak any other languages? If so, which ones?

How long have you been in the US?

How long do you plan to stay in the US?

Education (Most Recently Completed)

Do You Have a Job Now?

Employer

Position

Total Household Income

Please provide proof of income (Recent pay stub, Award letter, Benefit Statement, Retirement/Pension Document or Insurance/Workers Compensation)

Work Status

Goals

Read English Speak English Write English Become US Citizen Get Driver's License Get A Job Other

Select All Days/Times for Tutoring

Monday Morning Monday Afternoon Monday Evening Tuesday Morning Tuesday Afternoon Tuesday Evening Wednesday Morning Wednesday Afternoon Wednesday Evening Thursday Morning Thursday Afternoon Thursday Evening Friday Morning Friday Afternoon Friday Evening Saturday Morning Saturday Afternoon Saturday Evening

Select All Libraries Where You Can Meet

Franklin Lebanon Mason Salem Township (Morrow) Springboro Waynesville

Do you have a preferred tutor type

Type of meeting

Ethnicity

How did you find out about Literacy Connections?

Emergency Contact Name

Relationship

Emergency Contact Phone

Emergency Contact Email

Our Location

Warren County Community Services, Inc

645 Oak Street, Lebanon, OH 45036
Phone: (513) 695-2100

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This website is supported by Grant Number 05CH012649 from the Office of Head Start within the Administration for Children and Families, a division of the U.S. Department of Health and Human Services. Neither the Administration for Children and Families nor any of its components operate, control, are responsible for, or necessarily endorse this website (including, without limitation, its content, technical infrastructure, and policies, and any services or tools provided). The opinions, findings, conclusions, and recommendations expressed are those of Warren County Community Services, Inc. and do not necessarily reflect the views of the Administration for Children and Families and the Office of Head Start.

Copyright 2026 © Warren County Community Services, Inc. All Rights Reserved.

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