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Peer Tutoring Request Form
First Name (including American name)
Middle Initial
Last Name
Major(s)
Minor(s)
Status at CUW
First Year
Sophomore
Junior
Senior
Graduate
Adult Learning
ESL
Other
Contact Information
Room Number (if living on-campus)
Address1
Address2
City
State
Zip Code
Preferred Phone Number
Alternate Phone Number
Email
Contact Information
For which course(s) are you seeking tutoring?
Include the course name/number, professor, and when the class meets.
What aspects of your performance in the above course(s) do you anticipate will improve through participating in peer tutoring?
When are you available for tutoring?
List your availability during the following times: Monday through Thursday, 8:30AM-9:00PM; Friday 8:30AM-3:00PM; Sunday 6:00-9:00PM
To maximize the benefits of tutoring, we expect that you will come prepared for each scheduled session by adhering to the following guidelines:
- Attend your class faithfully
- Read the material assigned for your course
- Complete as much of the assigned homework as possible prior to meeting with you tutor
- Be ready with questions for your tutor
You must attend each tutoring appointment. If you cannot attend or do not need help for a particular session, you are required to cancel the appointment 24 hours in advance by calling
AND
emailing your tutor. If you miss two consecutive appointments without informing us, you automatically will be dropped from the schedule. You will then need to meet with the ADLRC to discuss your participation in the peer tutoring program.
I understand the above policy.
Full Name (Please use full legal name)
Initials
NOTE: - The information on this form, including your phone number, will be shared with your tutor.
•
Security Code
Enter the alphanumeric characters shown below. This requirement is to prevent automated submissions.