SUCCESS Learning Coach Request Form
Please submit this Learning Coach request form if you are interested in working with the Learning Coach and a part of either ALANA Men in Motion or Student Ambassador Mentorship Program (SAMP). Once the request form is complete, the Learning Coach, Morgan Curtin, will reach out to you.

Learning Coaches support student success by improving skills in:
  • Learning Strategies and Study Skills (note-taking, exam preparation, reading comprehension, etc.)
  • Time Management and Organization
  • Procrastination and Motivation
  • Navigating College (interpreting syllabi, talking with instructors, completing an incomplete grade)

If you are not a member of either program or are looking for tutoring services, please utilize CAPS Tutoring and Learning Coach Services. 

If you are filling out this form on a student's behalf, please complete the following questions with the student's information unless otherwise specified.
Email *
Who is filling out this form? (if someone other than the student). Please complete the rest of the form with the student's information.
Full Name *
Pronouns
Student ID *
HCC Email *
Phone Number *
How do you prefer to be contacted? *
Are you a member of the ALANA or SAMP Programs? *
Check the boxes for the area(s) you need support with (select all that apply) *
Required
Please tell us a little more about the area(s) in which you need support. *
Is there anything else you would like to tell the Learning Coach?
When would you like to start working with the Learning Coach? *
How do you prefer to meet with the Learning Coach?
Clear selection
Have you worked with a Learning Coach before? *
When are you available to meet with the Learning Coach?
Monday
Tuesday
Wednesday
Thursday
Friday
9 AM
10 AM
11 AM
12 PM
1 PM
2 PM
3 PM
4 PM
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