TUTOR APPLICATION

Date:

Name:

Address

City, State

Zip Code

Home Phone (w/area code)

Cell Phone (w/area code)

E-mail

ACADEMIC INFORMATION

Undergraduate Major:

Overall Grade Point Average:

Graduation Date:

IF APPLICABLE

Graduate Major:

Overall Grade Point Average:

Graduation Date:

TUTOR INFORMATION

Subject areas you are capable of tutoring:

Have you ever worked as a tutor before?
Yes
No

If so, where did you tutor?:

REFERENCES

Please list two faculty or staff references; include name, phone number and email address (please include at least one U of L faculty or staff reference).

EMPLOYMENT

Employer:

Employed From: To:

Address:

Title:

Responsiblities:

Employer:

Employed From: To:

Address:

Title:

Responsiblities:

Do you work elsewhere on campus?
Yes
No

Home Department:

By submitting this application, you are acknowledging that you have a minimum of a 2.5 cumulative grade-point average and a 3.0 grade-point average in the courses you wish to tutor and have completed forty-five (45) semester hours.
Initials

The University of Louisville 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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