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.

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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 Preperation
  Writing/Assignments
Other (please explain)