Tutor Request Application

Name(first last): Student ID# (no dashes):
Date (mmddyyyy): E-mail address:
Phone (no dashes):
Hill College E-mail address:
   *Most correspondence will be done through your Hill College email



I am requesting tutoring at:   I am requesting tutoring for:
I need tutoring in the following courses:
  Best time for me to receive tutoring is:
Days: Times:
  How often do you need tutoring:
Once a week Twice a week


Select "Yes" or "No" for each of the following statements
I qualified for the Pell Grant or other grant aid this semester: Yes No
At least one of my parents graduated from a four-year university: Yes No
I have a documented physical or learning disability on file with Hill College: Yes No
I am currently on Academic Probation: Yes No
Select the type of degree you are currently working towards:
  AA (Associate of Arts)  
  AS (Associate of Science)  
  AAS (Associate of Applied Science)  
  CT (Certificate of Technology)  
  CC (Certificate of Completion)  
Please indicate your current major:
Select "Yes" or "No" for each of the following statements:
Are you an international student? Yes No
Are you a Veteran? Yes No



I have reviewed, understand and agree to the requirements, conditions and expectations regarding participation in the Tutoring Program at Hill College listed on the Tutoring Website.
Once the application is submitted, I understand that it could take 5-7 days before I am notified by a tutor or a tutor coordinator.