REQUEST FOR TUTORING |
Please complete this form and return it to The Center for Student Success, 3rd floor, Room 318 Hodgin Hall.
Student-Athlete's Name: __________________________ Classification: ___________________
Sport: _________________________________________ Telephone: ______________________
Campus Address: _________________________________________________________________
(Residence Hall, & Room Number)
On Campus/Off Campus Mailing Address: ______________________________________________
Please indicate below the subject/course name and number for which you are requesting additional tutoring.
Course & Course # |
Course Name |
Time/Day |
Instructor |
I am available for tutoring on the following days and times.
DAYS |
TIME AVAILABLE |
| SUNDAY | |
| MONDAY | |
| TUESDAY | |
| WEDNESDAY | |
| THURSDAY | |
| FRIDAY | |
| SATURDAY |
I understand that if I am unable to attend a scheduled appointment, I must contact the
Coordinator for
Academic Monitoring of Student-Athletes. I also understand repeated abuses will result in
losing the
privilege for individualized tutoring.
Student-Athlete's Signature: ___________________________________ Date: ________________
To Be Completed by the CAM Date Approved: _________________________________________ Tutor Assigned: ________________ Date and times tutoring will take place_______________________________________________________ Course/Course # and Name: ________________________________ Location ______________________ |