| Semester |
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| Year |
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| Name |
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| Class |
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| Intended Major |
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| Primary Phone |
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| Secondary Phone |
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| Email |
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Course Name and Section you're requesting help with
Please fill out a form for EACH class you would like a tutor for |
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| Instructor |
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| Please indicate days and times you are available to meet with a tutor |
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| Problem Areas |
I have trouble understanding the readings.
I have trouble managing time.
I have trouble taking notes in class.
I have trouble taking notes from the textbook.
I have trouble taking multiple choice or true/false tests.
I have trouble writing essays.
I have trouble preparing for tests.
I have trouble with course content. |
| Please indentify the content that you are having difficulty with |
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| Have you spoken or communicated with the instructor about the difficulties you have had? |
| Yes No |
| Is this the first time you've taken the course? |
| Yes No |
| On average, how much time do you spend studying or doing homework for this course? |
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| How many credits are you currently taking? |
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| Are you currently working? |
| Full Time Part Time |
| Do you need a one time session or reoccuring tutor session? |
| One Time Reoccuring |
| Would you prefer to work one on one with the tutor or in a group session? |
| One on One Group |
| Who referred you to the Academic Support Center? |
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As a student seeking tutoring, I commit to the following:
I will be here on time.
I will come prepared with books, notes, homework assignment, etc..
I will attend class and take notes.
I will work on my own as much as possible outside of the session.
I will come prepared with specific questions or things to work on.
I will communicate with my professor.
I will notify the tutor or Academic Support Center if I am unable to attend my session.
By submitting this form, I agree to the above statements.
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