NAME
LAST FIRST  MI 

SSN

CAMPUS/LOCAL ADDRESS
(If this is a fraternity/sorority, please write out full name)

TELEPHONE

E-MAIL

MAJOR

CLASS YEAR
Class of '99  Class of '00  Class of '01  Class of '02

PLEASE CHECK IF YOU ARE REGISTERED
WITH DEBBIE HAMILTON'S OFFICE

Note: There will be no open tutoring for courses that are Supplemental Instruction unless given permission by an authorized member of the Advising & Learning Assistance Center.

TUTOR REQUEST(S)

COURSE NUMBER TITLE 
COURSE NUMBER TITLE 
COURSE NUMBER TITLE 
COURSE NUMBER TITLE 

I have read and agree to abide by the Tutee Responsibilities

SIGNATURE DATE