Academic Support

Tutoring Request Form

Please fill out the form to request tutoring:

Please correct the following errors:

Student ID:

Your College-Wide ID.

Name:

First Name

Last Name

Email:

Phone:

Course Name:

Is this for an Online Class?

Yes No

Instructor:

Inform my instructor?

May the Academic Support Center inform your instructor that you have requested tutoring for his/her class?

Yes No

Additional Info:

What grade do you wish to receive in your course?

Are you a visual, auditory or kinesthetic (learn by doing) learner?

What do you wish to gain from attending tutoring sessions?

By submitting this form, you agree to complete an online evaluation of tutoring services. This evaluation will aid Academic Support in improving our services to better serve students.

I Agree