Application to Request a Tutor

TUTOR REQUEST FORM

Date	Semester
Name	Student I.D. #
Local Address	Local Phone #  Other Phone #
Email	Major
	Year:      Grad      Sr      Jr      Soph     Fresh
Please answer the following questions
In what Subject(s) do you need Tutoring in?
Course Name	Course #
Have You used this Service Before ?  Yes    No
If yes, in what course?
Please chcek one:
I am Interested in Study Groups I would like the names of tutors only
How did you learn of our service?
Advertising Advisor Athletic Department Brochure Coach Friend Instructor Other     Please Specify
Note: Tutoring fees are negotiated between the student and the tutor and should be discussed before you begin your sessions. The Office of Academic Support Services recommends fees be in the range of $8 to $12 per hour.