Student Tutoring Center "We are here to help you succeed"

Student Request Form for FREE Tutoring

Student Name
Bengal Number
Phone(s)
Email Address
How often do you check the above Email address?



Mailing Address
City
State
Zip
Do you have a documented disability?

LIST THE COURSE(S) OR PROGRAM FOR WHICH YOU WOULD LIKE TUTORING:



Example:		 Class or Program Instructor Time
Electronics R. Katsilometes 8a-4p
ENGL 102 Dr. Katsilometes 10a MWF

HOURS AVAILABLE FOR TUTORING:

Check the boxes indicating which hours you ARE available for tutoring.

MON TUE WED THU FRI
7am-8am
8am-9am
9am-10am
10am-11am
11am-12pm
12pm-1pm
1pm-2pm
2pm-3pm
3pm-4pm
4pm-5pm
5pm-6pm

You must have an email client program (such as Outlook Express) set up on your computer to be able to submit by email. If you do not have email client program on your computer, print out the form and mail to:

Resource Center
Roy F. Christensen Building
Campus Stop 8380
Pocatello, Idaho, 83209-8380

Or hand in to Resource Center staff at:

Roy F. Christensen Building
3rd floor, room 365
Last Modified: 04/01/10 at 08:45:34 AM