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  Graduate 

Have you tutored for The Learning Center before?

Yes 

No   If no, check with LC staff whether or not you must submit an I-9 form in orderto get paid.

Have you attended a tutor training session?

Yes If yes,give date 

No 

All tutors are required to take some form of tutor training this academic year. If you did not attend a session, you should sign up at the time you submit this application for assignment to the appropriate training session. 

Number of hours/week you can tutor 
NOTE: Graduate students may not be paid for more than 20 hours per week (total) if work on campus without expressed permission, in writing, from the Graduate School. Undergraduates with financial aid should check with the Financial Aid office for limitations on their earnings.

I have read and agree to abide by the Tutor Responsibilities

SIGNATURE DATE 

Read through the entire course list and note ALL the courses you are willing to tutor. Then, list them in the spaces provided below. NOTE: All courses for which two or more students are signed up to be tutoredwill be treated as group courses.

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

Thank you for taking the time to fill out the questionnaire