LEARNING ASSISTANCE CENTER TUTORING APPLICATION FORM
Semester ____________________
Office Use Only
SSSP
VSST
Pend
LAC
Please Print Clearly
Name
Date
Female
Male
Address
(street)
Apt. #
City, Zip
Phone (C)
Preferred #
Our database will send text alerts to you related to your tutoring schedule. If you do not want to receive the text alerts, please inform the front desk.
COURSE(S)
IN WHICH YOU NEED TUTORING
FOR OFFICE USE ONLY
COURSE#
PREFERRED TUTOR
(S)
TUTOR
DAY & TIME
DATE
COMMENTS
DATE
REVISED
CHECK ONLY TIMES YOU ARE AVAILABLE FOR TUTORING.
THE MORE TIMES YOU CHECK, THE GREATER OPPORTUNITY YOU HAVE FOR
PLACEMENT. CHANGES WILL DELAY YOUR APPLICATION.
TIME
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
9-10AM
OFFICE CLOSED
OFFICE CLOSED
10-11AM
OFFICE CLOSED
11-12PM
OFFICE CLOSED
12-1PM
OFFICE CLOSED
1-2PM
2-3PM
3-4PM
OFFICE CLOSED
4-5PM
OFFICE CLOSED
5-6PM
OFFICE CLOSED
OFFICE CLOSED
OFFICE CLOSED
6-7PM
OFFICE CLOSED
OFFICE CLOSED
OFFICE CLOSED
7-8PM
OFFICE CLOSED
OFFICE CLOSED
OFFICE CLOSED
8-9PM
OFFICE CLOSED
OFFICE CLOSED
OFFICE CLOSED
THIS FORM WILL NOT BE ACCEPTED UNTIL BOTH SIDES ARE COMPLETED AND SIGNED.
Submitting your name and student ID number, verifies that the
information on this form was provided by you and is true to the best of
your knowledge.
ATTENTION STUDENTS
Welcome to the Learning Assistance Center. We hope your semester is off to a good start. We look forward to working with you in
achieving academic success by providing tutoring services in a timely fashion. In order for us to meet your needs promptly, we ask for
your cooperation. Listed below are some suggestions to save time and to help us make tutoring assignments efficiently:
Please indicate the tutor name if you wish to be tutored by a particular tutor. We do not promise that you will be assigned to your
preferred tutor, but we will try our best.
Schedule change requests will be entertained only twice unless there is a serious reason for the third rescheduling request.
Additional requests may take longer, be put on hold, or in the event of limited tutors’ availability may be asked to use drop-in hours
If you need help with drug calculations, please indicate it clearly on your application, as we can assign you to a math tutor instead of
assigning you to a nursing tutor.
Help during drop-in hours is rendered ONLY for 15 minutes. You may get more than 15 minutes if no one else is waiting to get help
YOUR RESPONSIBILITES AS TUTEE ARE AS FOLLOWS:
Contact the LAC if you have not heard from a tutor within two (2) weeks of making a request.
Be on time for each tutoring session
Please put your phone on vibration or silent mode. Be considerate to your fellow students and tutors.
Be prepared for tutoring sessions with your textbook, notes, syllabus, and all other required materials
Models in A&P room (RCF 356) can be viewed only if a tutor is present in the room.
Notify your tutor if you’re unable to keep an appointment or call 443.518.1320
After two (2) “No shows”/cancellations, you will be dropped, and will need to reapply. .
We hope you will understand that just like you, other students have needs for tutoring and we want to be able to provide help to
all the students who ask for help. If you have any questions, please do not hesitate to ask us. Thank you.
IF YOU UNDERSTAND THESE RESPONSIBILITES, PLEASE FILL IN YOUR NAME AND STUDENT ID NUMBER BELOW
STUDENT NAME:______________________________________ STUDENT ID NUMBER:_______________ DATE:____________