Tutorial/Learning Center Application

For Subject Area Tutor

Name:_________________________ I.D. Number:__________________________

Local Address:

_____________________________________________________________________

Local Phone:________________________________________________

Home Phone: (_____)_______________________

Class:_______________________ Major:__________________________

G.P.A: _____________________(major)_______________________(overall)

In which subject(s)? _________________________________________________

(Please enclose a current, non-official transcript)

Will you have another job this term? Yes______ No_______

If yes, please explain:

__________________________________________________________________

Are you eligible for work study? Yes______ No _______

If yes, what amount? ______________________________

Previous Work Experience: (On and Off campus)

Why do you want the job? (Please explain in some detail.)

Educational Background: (Please explain how it relates to this position)

Supply 3 References: Name, Email, Telephone #

1)______________________________________________________________________

2)______________________________________________________________________

3)______________________________________________________________________

Please complete the Semester Schedule form below.

NAME _________________________

SEMESTER SCHEDULE

Please cross out times you are not available.

Write “prefer” in those time slots when you would prefer to work.

How many hours total would you like to work? __________

CAMPUS PHONE ________________________

PERMANENT HOME PHONE _______________________________

E-MAIL ADDRESS ______________________________