Fillable Tutor Application 8-2015fillable Student Support Services

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Tutor Application 8-2015fillable Student Support Services

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Center for Student Success
Swisher Library, 3
rd
Floor
Peer Tutor Application Form
~ Please return with a current copy of your JU transcript for review ~
Applicant’s Name: ________________________________________ Date: __________________________
Student Number: ___________________________ Anticipated Graduation Date: ___________________
JU Email: @jacksonville.edu Birth Date: __________________________________
Phone: ___________________________________ Alternate Phone: ______________________________
Current Mailing Address:
_________________________________________________________________________________________
Street Apt# City State Zip Code
Current cumulative GPA: _____________________
Education
Major (s) & Minors: ____________________ __________________________ ______________________
Semester Standing
Please check the semester standing that applies to you.
Freshman Sophomore Junior Senior Graduate
JU Courses
List a minimum of 10 JU courses that you are qualified to tutor. (You must have a “B” or better in each course.)
You must be willing and able to tutor prerequisite courses in your majors and minors. For example, if your major is in
one of the business disciplines, you must be willing and able to tutor MATH 112. No exceptions.
________________________________________ _______________________________________
________________________________________ _______________________________________
________________________________________ _______________________________________
________________________________________ _______________________________________
________________________________________ _______________________________________
Faculty Recommendations – (minimum of three in your main subject areas)
Please let us know who will be sending us recommendations for you.
1) ______________________________ 2) ______________________________ 3) ____________________________
Other Information
Are you…..
A student athlete? YES NO (If yes, what teams are you on? _____________________)
NROTC? YES NO
A Greek organization member? YES NO (If yes, which organization? ________________________)
An Honors student? YES NO
A transfer student? YES NO (If yes, please send unofficial transcripts to our office.)
Please list any clubs, organizations, and activities that you are currently participating in and the role that you
have. We are particularly interested in any leadership roles that you assume.
_______________________________________ _________________________________________
_______________________________________ _________________________________________
_______________________________________ _________________________________________
Past/Current Employment (if applicable)
1_________________________________ ____________________ ________________________
Business name Manager Phone Number
________________________________________ ____________________________________________________________
Position Reason you left
Main Duties:
2_________________________________ ____________________ ________________________
Business name Manager Phone Number
________________________________________ ____________________________________________________________
Position Reason you left
Main Duties:
Is there anything else you would like us to know about you?
Contractual Obligations
1) During my first year of employment, I will attend a minimum of 10 Tutor Training Sessions. If
circumstances beyond my control prohibit me from attending the meetings, I will document 10 hours of
independent research on tutoring skills topics.
YES NO
If you said No, please explain: _______________________________________________________________
2) I agree to check my JU Email every week day for important information and updates. This is very important!
YES NO
If you said No, please explain: _______________________________________________________________
3) If I am struggling in my own coursework, I will let the Student Success Coordinator know.
YES NO
If you said No, please explain: _______________________________________________________________
I certify that I am currently enrolled at Jacksonville University and have a minimum
cumulative GPA of 3.0. I realize that this position requires great maturity, dedication,
and integrity. I am more than ready to take on this responsibility. I will not let JU down!
Student Signature ____________________________________ Date ________________
(Please type your full name in the box above for electronic submission)
Supervisor Signature _________________________________ Date ________________
OFFICE USE ONLY
HIRED: YES_____ NO_____ START DATE:____________
NOTES:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Please return this application along with a current copy of your most recent transcript to:
Pat Krauss, Student Success Coordinator
Center for Student Success
Swisher Library | 3
rd
Fl. | #308
904.256.1680
pkrauss@ju.edu | tutoring@ju.edu
http://www.ju.edu/studentsuccess
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Tutor Application 8-2015fillable Student Support Services

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Completed 19 February 2020

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