Tutoring Request Form
First Name
*
Last Name
*
Student ID
*
Academic Program (Major)
For what class are you requesting tutoring?
*
Instructor Name
Phone Number
-
Area Code
Phone Number
Email
*
Which Mid Campus Location do you prefer?
No Preference
Harrison
Mt. Pleasant
Zoom
Please indicate times when you are available for a tutoring session.
*
Rows
Mon
Tues
Wed
Thur
Fri
8:00am
8:30am
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:30pm
6:00pm
6:30pm
My signature below indicates that I release my contact information to a tutor for the purposes of arranging a meeting time.
*
Submit
Should be Empty: