EOP Tutoring

UNIVERSITY AT ALBANY
TUTOR APPLICATION FORM

Name: Spring    Fall

# of Credits Enrolled in this Semester? Previously Enrolled as a Tutor? Yes    No

Local Mailing Address
Permanent Address

Local Phone # E-Mail Address

Student ID # Social Security #

Currently Employed on Campus? Yes    No

If employed, Position Location

Major: Minor:

Class Year:    Fr    So    Jr    Sr    Grad

Check tutoring position of interest. (You may check more than one.)
University Tutor
Independent Tutor
EOP Tutor

COURSES INTERESTED IN TUTORING
(Preference Order) Example: MAT100
(Include the grade you received in each class)

1. 2.

3. 4.

Department Reference (Professor/Department)

Name Phone Number

Name Phone Number

(one reference must submit a letter of recommendation)

Name:	Spring Fall

# of Credits Enrolled in this Semester?	Previously Enrolled as a Tutor? Yes No

Local Mailing Address	Permanent Address

Local Phone #	E-Mail Address

Student ID #	Social Security #

Currently Employed on Campus? Yes No

If employed, Position	Location

Major:	Minor:

Class Year: Fr So Jr Sr Grad

Check tutoring position of interest. (You may check more than one.) University Tutor Independent Tutor EOP Tutor

COURSES INTERESTED IN TUTORING (Preference Order) Example: MAT100 (Include the grade you received in each class)

1.	2.
3.	4.

Department Reference (Professor/Department)
Name	Phone Number
Name	Phone Number
(one reference must submit a letter of recommendation)