Prospective Tutor

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:

List the course(s) in which you are qualified to serve as a tutor:

Please check the Campus(es) in which you are available to tutor:
Flanagan (Lincoln) Knight (Warwick) Liston (Providence) Newport

Hours per week you can tutor:
May we give your phone # / e-mail to the student requesting tutoring? Yes No

Please check the boxes for all days and times you are available for tutoring.

* 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

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9am-10am
10am-11am
11am-12pm
12pm-1pm
1pm-2pm
2pm-3pm
3pm-4pm
4pm-5pm
5pm-6pm
6pm-7pm
7pm-8pm