Request A Tutor Form | Allegany College of Maryland

First Name:

Last Name:

ACM Student ID #:

ACM E-mail:

Phone Number:

May we contact you by text message?

Address:

City:

State:

Zip:

Major:

Please select which semester you will need a tutor:

Please select which term you will need a tutor:

Please select the campus you will be attending:

Subject(s) in which Tutor is requested:

Please select how you were referred to tutoring services:

Available Hours (Days/Times you will be able to meet with a Tutor):

Semester Course Schedule (Course Title, Number, Instructor, and Scheduled Time):

Is English your second language?

I would be willing to work in a group tutoring session:

If a tutor is not available, I would be willing to join a small study group:

Comments/Requests (example: Request Specific Tutor, Special Accommodations, etc.):

Allegany College of Maryland does not discriminate against any individual for reasons of race, sex, color, religion, national or ethnic origin, age or conditions of handicap in the admissions and treatment of students, educational programs and activities, scholarship and loan programs, hiring of faculty and staff, or any terms and conditions of employment.

Applicant's Signature: