Academic Support Tutoring Program

Tutor Application

Tutoring assistance is provided through Academic Support for all Willamette undergraduate students.

Note: Field Names in Red are Required.

Name:*
Phone:*
Email:*
Student ID#:*
Major:*
Year in School:*
Date:*
Work Study:	Federal Willamette None

List classes for which you are able to tutor

Subject 1

Subject:*
Classes Taken:*
Grades Received:*

Subject 2

Subject:
Classes Taken:
Grades Received:

Subject 3

Subject:
Classes Taken:
Grades Received:

Subject 4

Subject:
Classes Taken:
Grades Received:

Subject 5

Subject:
Classes Taken:
Grades Received:

Please list faculty members who can serve as references

Reference 1

Name:*
Email:*

Reference 2

Name:*
Email:*

Reference 3

Name:*
Email:*

How many hours a week would you like to tutor?*
Please list any experience in tutoring you might have:
Work with students with disabilities	Do you have experience or an interest in working with students with disabilities?

Tutor Agreement

To assist you, the student, in obtaining the maximum benefits from your tutoring session, we request that both the student and the tutor agree to the terms outlined in the Academic Support’s Tutor/Tutee Guidelines.

Mutual respect and consideration is the key to a productive relationship. Please remember to keep the communication channels open.

I have read the Academic Support's Tutoring Guidelines and agree to the terms.*

I Agree