Date

Sport

Name

Cell Phone

Local Phone

Email

Are you currently in a Required Study Hall?
Yes No

Have you met with your instructor during office hours.
Yes No

Why not?

Course and Number (Ex:Math 1530)

Section(Ex: 001)

Title(Ex: Prob/Stats)

Instructor(Ex: Smith, Jones)

Meeting Day/Time(Ex: MWF 8:15-9:10)

In your own words please summarize the trouble you are having:

Please check all boxes that you are available to tutor:

Tutor Name

Tutor Phone#

Tutor Email

Date Tutor Contacted

Date of Session 1:

Scheduled Days/Times:

Location:

Comments:

I will meet with a tutor at an assigned time and place. I know it is important to be on time for each session and set a regular meeting time. I understand that sessions cannot be conducted off campus or in a dorm room. All tutoring must conclude before 9:00 PM.

I understand it is my responsibility to notify the tutor ahead of time if it is impossible to meet at the scheduled time. If the tutor cannot be contacted, I will notify a member of the Academic Staff so the message can be relayed to the tutor.

I understand that two absences from tutoring sessions will be grounds for termination from my tutoring opportunities.

I will come to the session prepared and ready to study, and will always review the assignment and have specific questions in mind to ask the tutor concerning the lesson.

I will attend class regularly. Tutoring cannot be continued successfully if students have excessive absences.

I will contact the Director of Academic Services if problems arise in the tutoring sessions that cannot be resolved by the tutor and me.

I understand the purpose of the tutoring program is to help me better understand material presented in class and have confidence to demonstrate this understanding in class and/or on tests. It is not the responsibility of the tutor to do assignments for me.

I understand that I will be evaluated by my tutor at the end of the semester, and that this information will be shared with my coach.

I UNDERSTAND MY RESPONSIBILITIES AND AGREE TO ADHERE TO THEM IN ORDER TO RECEIVE TUTORIAL SERVICES.

Date