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Request for Tutoring

Year:
 
Student I.D. Number:          Name:   
                                                                                  First                                           Middle                                           Last
Address:         City:        State:          ZIP:
 
Phone Number:     (By inserting your phone number you are giving permission for its release to your tutor)
 
Email Address:     (Required)
 
Specify Degree:                          Major:          
 
Do you need special accomodations?:
 
I request tutoring for:   (Example:  MATH1500)      Instructor Name:  
 
Term:         Preferred Times:  1)   2)
(Examples:  1st 5 Weeks Summer, Summer, Fall, Spring, etc.)
 

Please indicate the times you are available each day:  (Check all that apply)

 

Monday    
8-9am 9-10am 10-11am 11-12pm 12-1pm 1-2pm 2-3pm 3-4pm 4-5pm 5-6pm 6-7pm 7-8pm 8-9pm 9-10pm
10-11pm 11-12am 12-1am
   
     
Tuesday    
8-9am 9-10am 10-11am 11-12pm 12-1pm 1-2pm 2-3pm 3-4pm 4-5pm 5-6pm 6-7pm 7-8pm 8-9pm 9-10pm
10-11pm 11-12am 12-1am
   
     
Wednesday    
8-9am 9-10am 10-11am 11-12pm 12-1pm 1-2pm 2-3pm 3-4pm 4-5pm 5-6pm 6-7pm 7-8pm 8-9pm 9-10pm
10-11pm 11-12pm 12-1am
   
     
Thursday    
8-9am 9-10am 10-11am 11-12pm 12-1pm 1-2pm 2-3pm 3-4pm 4-5pm 5-6pm 6-7pm 7-8pm 8-9pm 9-10pm
10-11pm 11-12am 12-1am
   
     
Friday    
8-9am 9-10am 10-11am 11-12pm 12-1pm 1-2pm 2-3pm 3-4pm 4-5pm 5-6pm 6-7pm 7-8pm 8-9pm 9-10pm
10-11pm 11-12pm 12-1am
   
   
 

I verify that I have read and understand the Tutee Policies and agree to permit the release of my contact information (email, phone number) to the tutor.

 

 


 

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Shawnee State University
940 Second Street
Portsmouth, Ohio 45662-4344
To_SSU@shawnee.edu
740.351.4SSU
TTY: 740.351.3159

Last Updated:
06.15.2009 11:00 AM

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