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Learning Center
English Tutoring Program
TUTOR REQUEST
Name:
,
Date:
20
(last)
(first)
Tel. #:
Cell
H
W
E-mail:
Male
Female
Student ID:
DVC COURSE FOR WHICH TUTORING IS REQUESTED
Course Title: Instructor:
Is English your first language?
Yes
No
If no, first language is:
1. What days and times can you come for tutoring? (Example: MW, 2-5 p.m.)
BELOW: 2. Put an X in ALL time slots available FOR TUTORING.
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
8:00
9:00
10:00
11:00
12:00
1:00
2:00
3:00
4:00
5:00
6:00
7:00
FOR OFFICE USE ONLY
:
TUTOR
FIRST MEETING
DAY AND TIME
ADD
DROP
ADD
DROP
TUTOR NOTIFIED
ADD LIST
SCHEDULE CARD
WORKSHEET
DAILY MASTER
TUTEE NOTIFIED
OfficialForms/StudentFolder/TutorRequest 2018
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Completed 16 February 2020

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