Request Tutor Registration Form

Are you currently receiving financial aid?
Yes
No

Courses I want tutoring for:

Please select the type of assistance you need (check all that apply):
Explain course material in a more detailed manner
Show me effective methods for finding answers to questions
Quizzing
Study Tips
Special Projects
Review material from classes
Review material for tests
Assist in problem solving
Other (please comment below)

If you selected Other above please put your comment here.

Please read the following learner guidelines thoroughly.

• I understand that Kirkwood will fund up to 2 hours of tutoring for 2 credit courses per semester.
• At the end of each tutoring session, I will sign my name in the space provided on my tutor's time sheet, verifying time tutored.
• I will not pre-sign the tutor time sheet.
• I will arrange all tutoring requests through the Tutoring Services office.
• I will report any problems I experience while working with my tutor and will alert the tutoring staff if/when I stop meeting with my tutor.
• I will not receive Kirkwood funded tutoring services from individuals with the following relationships: * relatives/family * friends * roommates * fiancee's * spouses *common law wives/husbands * boyfriends/girlfriends
• I will not be selective in requesting a tutor and will accept the match that the tutoring staff provide me.
• I will not apply to be a tutor in the same semester as I am a student in that course.
• I will contact the tutor immediately and leave a message if I will not be able to meet for a session. If I cannot reach the tutor, I will call the tutor desk (398-5425) and leave a message with them to inform my tutor.
• I understand that 3 no shows or excessive tardiness on my part may result in loss of tutor privileges. Your tutor does not get paid if you don't show up.
• If I exceed the 2 hour/week limit without prior approval of the tutor desk, I will be responsible for paying the tutor with my own funds.

In consideration of Kirkwood funding tutoring services for me, I agree to conform to the tutoring rules and regulations for learners.

I understand that violation of these learner expectations will result in termination of my eligibility for receiving tutoring services.

Tutoring Services will contact you by telephone within two working days once you submit this application. Please make sure the telephone number you listed above is current.