Academics

Date: ____________________________________

Class: ________________________

Name: ___________________________________________

Address: ___________________________________________

Major: ________________________

GPA in Major: ______________

Phone # : _____________________________

Cell phone # : _____________________

E-mail Address: _________________________

Social Security # ____________________________

Date of Birth: ___________________

Are you work study? _________________

Permanent Address: _____________________________________________

Permanent Phone: ________________________________

NOTE: If hired, tutors must be willing to participate in tutor training and attend at least two meetings per semester.

Please answer the following questions for each subject/course listed.

Have you had prior experience tutoring this subject/course?

Awards and Honors received:

Please list the days and times you are available for tutoring.

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