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Tutor Request Form

Full Name Current semester (eg. Fall 2010)

Primary Phone Secondary Phone

UWFox Email Address * Required

List the course(s) you would like assistance with.

Course # Grade Professor

Course # Grade Professor

Course # Grade Professor

Indicate the times (during our open hours) that you are available to come into the Learning Resource Center.

Monday (Open from 8am-7pm)/Time:

Tuesday (Open from 8am-7pm)/Time:

Wednesday (Open from 8am-4pm)/Time:

Thursday (Open from 8am-4pm)/Time:

Friday (Open from 8am-4pm)/Time:

Thank you for completing this form in its entirety. If you do not hear from us via email within 48 hours, please contact:

Kathy Gilmore