Peer Tutor Request

PEER TUTOR REQUEST FORM
I understand that academic progress information may be shared with the assigned tutor. This includes assignment grades, course progress reports, academic history and previous tutoring information.

Note: Press the TAB key to move between fields. Press the "SUBMIT" button at the end of the form to transmit your completed form. We will attempt to reply within 48 hours to questions or comments.
Your Information
Name
Address/Box #
Local Phone Number
Cell Phone Number
Email Address
Year Freshman:   Sophomore:   Junior:   Senior:  
Status Full Time:   Part Time:  
Days and Times
Please list all times you are available to meet with your Peer Tutor.


Course Information
Course Number & Title
Professor/Instructor
Approximate Course Grade
Please check any of the following areas with which you are experiencing difficulty.
  Reading Assignments
  Concepts
  Note Taking
  Processing
  Problem Solving
  Exam Preparation
  Writing/Assignments
Other (please explain)