Peer Tutor Learning Support Center
Tutor Application
Name ___________________________________ MDCC ID #__________________________
Address__________________________________ Phone_______________________________
_________________________________________Residence Hall ________________________
P.O. Box _________________________________________
E-Mail Address____________________________________
Classification: ( ) Freshman ( ) Sophomore
( ) Graduate Anticipated Date of Graduation (semester/year) _________________
Major_____________________________ Minor __________________ Cum. GPA __________
Are you eligible to receive financial aid assistance through work-study?
____ yes ____ no ____ I am not sure if I am eligible.
Do you have prior commitments that will conflict with a tutoring schedule (i.e. jobs, extra-
curricular activities, family)? ______ yes ______ no
If yes, explain below:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Course(s) you are interested in tutoring:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please indicate your availability (days & hours) to tutor during the semester: (i.e. Mondays
2-4pm, Tuesdays 3-6pm, Wednesdays common hour, etc.)
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
Please attach a current transcript with this application.
Once all application materials are received, you will be contacted for an interview.
Mississippi Delta Community College does not discriminate on the basis of age, race, color, national origin, religion, sex, sexual orientation,
gender identity or expression, physical or mental disability, pregnancy, or veteran status in its educational programs and activities or in its
employment practices. The following person has been designated to handle inquiries regarding the non-discrimination policies: Steven J. Jones,
Vice President of Administrative Services, Tanner Hall, Suite 202, P. O. Box 668, Moorhead, MS 38761, 662-246-6304; EEOC@msdelta.edu.