Please provide the following information and return it back to the Success Center Campus Coordinator at your campus. Student Name: Student ID #: Street Address: City: State: Zip Code: Home Phone #: Cell/Work Phone #: E-mail: Program of Study: # of credits accumulated: GPA:
Hours per week you can tutor: May we give your phone # / e-mail to the student requesting tutoring? Yes No
Days and Times you are available to tutor:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
* Please have faculty member sign a separate faculty recommendation form for each course you want to tutor and return it back to the Success Center Campus Coordinator. Have you: 1. Answered all questions? 2. Finished your availability? 3. Obtained teacher recommendation forms?
Faculty Recommendation Form