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2021-2020 Tutoring Request
Please submit this form to request a tutoring session.
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* Indicates required question
Name (Last, First)
*
Your answer
Contractor currently working for:
*
Your answer
Phone number
*
Your answer
Email Address
*
Your answer
Class Year (choose one)
*
1st Year
2nd Year
3rd Year
4th Year
Class Night
*
Monday
Tuesday
Wednesday
Thursday
Date(s) Available for Tutoring (please select two)
*
Monday
Tuesday
Wednesday
Thursday
Required
Time(s) Available for Tutoring (please select two)
*
5:00 PM
5:30 PM
6:00 PM
6:30 PM
Required
Subject(s) Requesting Help With:
*
Your answer
I understand and agree to comply that if tutoring is scheduled and not attended or cancelled at least two hours prior to the scheduled date and time a $20.00 fee with be required. (E-Signature)
*
Your answer
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