Tutor Request Form
 

This application should be returned to:
Academic Initiatives For Mentoring Students
University of North Carolina at Charlotte
318D Fretwell Building
Charlotte, NC 28223-0001

 

 

 

 

 

 

 

 

 

 

 

Date ________________________________   SID#   ________________________

Full Name ___________________________________________________________

Local Address ________________________________________________________

City ______________________________    State ______________  Zip _________

Phone ____________________________   E-mail ___________________________

Major ___________________________  Classification ________________________

List of courses in which you need tutorial assistance

Course/Section Number

 Instructor

Time/Day
     
     
     
     

 

Available Tutoring Times

  Days   Available Times   Assigned To
  Monday     Day
  Tuesday     Time
  Wednesday     Course
  Thursday     Location
   Friday     Tutor

 

Signature:______________________________

   Date:______________________________

Tutor Request Form.Copyright © 1999 [Academic Initiatives For Mentoring Students]. All rights reserved. Revised: September 28, 2004
AIMS Home SAFE UTOP PRODUCE Bridge to the Doctorate TRACE FORMS Newsletter UNCC Home