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Tutor Application Form

Personal Information
First Name:
Last Name:
Nick Name:
e.g. "Bob" for "Robert" if this is how you prefer to be called
Local Address:
Town:
Zip Code:
Local Home Phone:
Local Office Phone:
UConn Email:
Secondary Email:
Academic Data
PeopleSoft ID:
Academic Status:    
Expected Graduation Date:
Major:
GPA:
Faculty Reference:
This person should preferably be an instructor at UConn.
Reference Email:
Tutoring Data
Do you have any previous tutoring experience?
Which Courses would you feel comfortable tutoring for?
Mathematics:
Physics:
Chemistry:
Statistics:
Other:
Other Obligations
If you work for other UConn departments, list them here. If not, leave blank.
How many hours do you work for other UConn departments?
Are you on workstudy?
General Comments
Please briefly describe what special qualities, characteristics,
or experiences you have to bring to tutoring in the Q Center:


                                                                                                                                                                                                                                                                                                                                                                                                               
 
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  Quantitative Learning Center
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Storrs, CT 06269-2200
Phone: (860) 486-1961
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