Northwestern University Academic & Student Services
TUTOR APPLICATION

NAME (Last): (First):
Address line 1: Apt. / Room #:
Address line 2:
City: State: Zip Code:
Home/Apt phone number:   Cell phone number (if applicable):   Other phone number:
Email address you actively check:

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ACADEMIC INFORMATION
UNDERGRADUATE INFO
Undergrad Degree From (school name): Major:
Overall Grade Point Average:  Graduation Date:

[If Applicable]
GRADUATE INFO
Grad Degree From (school name): Graduate Program of Study:
Overall Grade Point Average: Graduation Date:
Are you currently working as a TA for NU? Yes No    If yes, please list courses you currently TA:

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EMPLOYMENT HISTORY
Company's Name:    Employed from to
Work Address line 1:
Work Address line 2:
City: State: Zip Code:
Supervisor's Name (Last): (First):
Daytime Telephone No. of Supervisor:
Job Title:
Responsibilities:
:

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SCHEDULING AND AVAILABILITY
Have you ever worked as a tutor before? Yes No    If so, where did you tutor?

Subject areas you are capable of tutoring:

Please check which types of tutoring you are interested in and available for (click here to view descriptions):
Learning Teams Drop-In Individual

Please check which days you are available for tutoring (please check ALL that apply):
M
T
W
TH
F
SA
SU
Individual Daytime Appts
Individual Evening Appts*
Drop-In
7:00pm-10:00pm
NA
NA
NA
Learning Team
7:00pm-10:00pm
NA
NA
NA

OTHER**

*Note: Individual tutoring hours may be held anytime- although you are free to schedule individual sessions during regular study skills hours.
**Please explain OTHER below:

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REFERENCES - Please list two faculty or staff references:
(Include Name and Phone Number for each reference)

Ref #1(Last name): (First): Ref #2 (Last name): (First):
Ref #1 phone number:                                        Ref #2 phone number:
                         
Have you read Northwestern's Academic Integrity and Tutorial Ethics Statement? (you will sign a hard copy later) Yes No
By submitting this application, you are acknowledging that you have a minimum of a 2.5 cummulative grade point average. A 3.0 grade point average in the courses you wish to tutor and have completed sixty (60) semester hours. I agree I disagree


Press to send your application or press to erase your answers and start over.

Northwestern University is an equal opportunity institution and does not discriminate against persons because of race, religion, sex, age, handicap, color or national origin.

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