International Peer Tutoring - Student Tutor Request Form

• Student Information

• Full Name

  Full Name * First Last
• Student Number *
• Phone number

  Phone number * - ### - ### ####
• Email *
• Preferred Contact Method
  Preferred Contact Method

  Email Phone Mail
• Student Type
  Student Type

  Undergraduate Regular Visiting Exchange

• Tutoring Information

• In what subject Areas would you like tutoring? Please specify course name and number.
• In which language(s) would you prefer tutoring?
  In which language(s) would you prefer tutoring?

  English Other Other
• Do you prefer individual or group tutoring
  Do you prefer individual or group tutoring

  Individual Group
• What do you want help with?
  What do you want help with?

  Understanding my course Improving my writing Getting ready for an exam/test Improving my reading Learning how to study better Understanding English Other = please specify Other = please specify
• When are you available to attend tutoring? Please specify add days and times (Monday to Friday) that you are available to meet with your tutor.

• The collection of personal information through this application is solely for the purpose of processing your Tutor Request Application, and will only be used as outlined in the attached reservation agreement. It is collected under 36(1) of the Freedom of Information and Protection of Privacy Act. If you have any questions regarding the collection of your information, contact our Information and Privacy Officer at 204.988.7538 or 515 Portage Avenue, Winnipeg, MB R3B 2E9.

• Spam Protection. Please answer this question:
  What is "ten" as a number?