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REQUEST FOR A TUTOR

 

Date of Application:

Name:              Student ID Number:

Address: 

City:          Zip Code: 

Telephone Number:      E-mail address:

Cell Phone Number:

* May we contact you by text message? Yes    No      Who is your provider?

Curriculum (Major):

Subject in which tutor is needed (Please complete a separate request for each course)

Course Title
Course Number
Instructor

 

* Available Hours (The times that you will be able to meet with the tutor) *

Monday
Tuesday
Wednesday
Thursday
Friday


Semester Course Schedule:

Monday:
   
Tuesday:
   
Wednesday:
   
Thursday:
   
Friday:

 

* Check one:

Is English your second Language   Yes No
Please keep my tutoring application confidential   Yes No
I would be willing to work in a group tutoring session.   Yes No
If a tutor is not available, I would be willing to join a small study group.   Yes No

Please select the campus you wish to be a tutor?
Cumberland Bedford Somerset

 

I give my permission to release my telephone number to other members of a study group.

E-Signature:  

Please click "Submit" only once.
Processing takes a few moments to complete.

 

 

 



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