CATS Tutor Request Form

Name Name * First Last
Preferred Email *
Preferred Phone Number Preferred Phone Number * - ### - ### ####
Is texting OK? *

Is texting OK? Yes No
Are you a member of SSS? *

Are you a member of SSS? Yes No
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If you answered Yes, please click here to request a tutor through the SSS program:

SSS Member Request a Tutor
I live *

I live On Campus Off Campus
Are you able to come to campus to receive tutoring? *

Are you able to come to campus to receive tutoring? Yes No
If unable to come to campus, what is your time zone?

If unable to come to campus, what is your time zone? Central East Coast Mountain West Coast Other - Specify Other - Specify
Course Information

Please give detailed information about the course(s) for which you are requesting a tutor.
Course 1 (Course Number and Name) *
Instructor's name for Course 1 *
Is this an online course?

Is this an online course? Yes No
Which session is Course 1 in? *

Which session is Course 1 in? 16 week session First 8 week session Second 8 week session
(Optional) Are there other courses that you would like tutoring in?
Are you an athlete? *

Are you an athlete? Yes No
Which sport?
Tutee's Responsibilities & Tutoring Contract

CAREFULLY READ EACH STATEMENT! TYPE YOUR INITIALS IN THE BOXES ACKNOWLEDGING THAT YOU UNDERSTAND AND AGREE TO ABIDE BY EACH STATEMENT.
I will attend class regularly, take notes, participate in class, and see the instructor as needed. *
I will attempt or complete my assignments and prepare questions BEFORE coming to the tutoring session. *
I will arrive on time for all tutoring sessions and prepared with my textbook, homework, notes or any other resource I need for tutoring. *
I will respect each other's differences and similarities, including but not limited to one's: culture, individual identity, age, sex, gender identity, race, ethnicity, national origin, religion, sexual orientation, disability, primary language, and socioeconomic status. *
(Optional) Is there any additional information you would like to include with your tutor request?
Today's Date Today's Date * / MM / DD YYYY
I have read and understand the responsibilities as a tutee to receive peer tutoring assistance. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

CATS Tutor Request Form

CATS Tutor Request Form

STOP If you answered Yes, please click here to request a tutor through the SSS program: SSS Member Request a Tutor

Course Information

Tutee's Responsibilities & Tutoring Contract

STOP
If you answered Yes, please click here to request a tutor through the SSS program:

SSS Member Request a Tutor