DCC PEER TUTORING PROGRAM

DanvilleCommunity College, 1008 South Main Street, Danville, VA 24541 Phone (434)797-6432

APPLICATION FOR PEER TUTORING

Circle Semester: Fall Spring Summer Year:______

Name: ______

Address: ______

City: ______State: ______Zip Code: ______

*Phone Numbers:Home: ______Cell______

*email address: ______*Student ID: ______

Subject(s) in which you desire tutoring:

Class Class Number Instructor Class Day(s) & Time

______

______

______

Is this the first time you are taking this course(s)? If no explain: ______

______

Is there a particular area you need help? (ex. fractions, order of operations, research, verb

use, commas, document format) ______

______

What do you think your grade is at this point? (circle one) A B C D F S U Don’t Know

Have you had a tutor in the LAC before? NO______YES______When______

How did you find out about the Peer Tutoring Program? SDV 100______Orientation______

Student ______DCC News______Instructor______Counselor______Other ______

Circle all the times you could come to tutoring and *preferred times

MonTuesWedThus Fri

8-98-9 8-9 8-9 8-9

9-109-10 9-10 9-10 9-10

10-1110-1110-1110-1110-11

11-1211-1211-1211-1211-12

12-112-112-112-112-1

1-21-2 1-2 1-2 1-2

2-32-3 2-3 2-3 2-3

3-43-4 3-4 3-4 3-4

4-54-5 4-5 4-5 4-5

5-65-6 5-6 5-6

6-76-7 6-7 6-7

7-87-8 7-8 7-8

PleaseRead and Sign Back

TUTORIAL SERVICE POLICIES FOR TUTEES

I understand that as a tutee, I have the responsibility to:

  1. Be present and on time for all tutoring sessions. If you cannot attend, will be late, or no longer need tutoring, please notify us by:
  2. Informing your tutor in advance, or

B. Calling: (434)797-6432

Attendance policy: Two absences without notice or three absences overall constitute voluntary withdrawal from the Tutorial Service. Any tutee that arrives ten minutes after the appointment time is considered late. Two late arrivals constitute one absence. *Note: Attendance policies will be strictly enforced.

  1. Come prepared; bring your completed homework, topic for papers, and questions to your tutoring session. Tutors will not do tutees’ assignments under any circumstances.
  2. Class attendance is required. Tutoring sessions are not substitutes for your classes.
  3. Cell Phones must be off or put on vibrate. Food and drinks are not permitted in the LAC or Library.
  4. Any complaints or problems concerning the Tutorial Service should be brought to the attention of the tutor coordinator. In addition, tutors and tutees have the right to request a change of assignment. These requests may not always be granted due to lack of available time slots.

I understand and agree to all of the above:

Signed: ______Date: ______

NOTE: The time of year and tutor availability may make finding a tutor difficult for some subject areas. The Tutoring Center will make every attempt to find a tutor in a timely manner and does not guarantee a tutor will be assigned.

The following questions are for statistical information only:

Gender: Male / Female Ethnic Background: ______

What is your major or program of study? (ex. AST, IT Track I, Liberal Arts, ADJ, Welding, Printing, First year Studies)

______

Are you a member of a household with someone who was directly employed in or who received income from a tobacco-related occupation during 1998 as verified by the 1040 Federal Tax Return or the Tobacco Indemnification Settlement payment letter? Or have you received assistance from the Tobacco Financial Assistance Program? Yes______No______

Are you funded by the Trade Act? Yes______No______

Are you a client of Workforce Investment Act and/or receiving funding through the WIA? Yes______No______

Are you a first generation college student (Your parents did not go to college)? Yes______No______

Danville Community College promotes and maintains educational and employment opportunities without regard to race, color, sex, ethnicity, religion, gender, age (except when age is a bona fide occupational qualification), disability, national origin, or other non-merit factors. Danville Community College prohibits sexual harassment including sexual violence.