Faculty Referral Form
The Learning Services Department is always looking for more persons to serve as tutors. To make a
recommendation, please provide student’s name, specific subject competencies, and an evaluation of
their abilities. Visit Tutoring to learn more about tutor minimum qualifications.
This form requires Adobe Reader 9 or higher. Do you have it? If not, download the current version.
Complete, save file for your records, then submit to Melissa Weston, Tutoring Services, Room L337,
at 815-802-8775 or email to mweston@kcc.edu.
Faculty Name:
Title:
Department:
Phone Number:
Email Address:
Student Name:
Student ID:
Recommended for Subject/Course:
Rate the student's expertise in content area:
Rate the student's ability to explain subject in practical and conceptual terms to others:
Rate the student's ability to work collaboratively:
Rate the student's ability to work one-to-one:
Rate the student's work ethic:
Rate the student's communication skills:
Rate the student's dependability/reliability skills:
Rate the student's maturity level:
I am recommending this student as a Tutor because:
Additional Comments:
If you have any questions, please contact Melissa Weston, Tutoring Services, Room L337, at
815-802-8775 or email mweston@kcc.edu.
Excellent
Excellent
Excellent
Excellent
Excellent
Excellent
Excellent
Excellent
Additional Comments
8/2015