Name: ___________________________________ Date: ________________
Address: __________________________________________________________
City/State/Zip:_______________________________________________________
Phone: _____________________________________________________________
Email: ______________________________________________________________
Your Degree Area: ____________________________________________________
Academic Advisor: ____________________________________________________
Tutors Requested for the Following Courses:
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Course Name |
Course Meeting Days and Times |
Instructor’s Name |
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Times that I am free to meet a tutor are [put an X on all the times that you are available—the more you indicate the easier it is to match you to a tutor!]
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Day/ Time |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
Saturday |
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8:00 am |
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9:00 am |
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10:00 am |
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11:00 am |
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12:00 pm |
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1:00 pm |
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2:00 pm |
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3:00 pm |
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4:00 pm |
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5:00 pm |
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6:00 pm |
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7:00 pm |
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8:00 pm |
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9:00 pm |