Application for Tutoring Position Registration Form

(Items with * must be filled or checked for application.)
PERSONAL DATA Today's Date: 5/23/2013
*First Name: *Last Name:
*Local Address:
*City:
*State:
*Zip Code:
*WCU Student ID:
*Phone Number: - -
*E-Mail Address:
*Number of Hours: ( 5 - 20 hours/week )
*Semester you desire employment: Fall Spring Summer
Home Address:
(if different from above)
Home Phone: - -

EDUCATION RECORD
*Current Classification: Freshman Sophomore Junior Senior Other
*Major/Program: *Department:
*Cumulative G.P.A.: (Minimum undergrad 3.0 / grad 3.25 )
Attach a recent transcript of grades if not a WCU student:
Other College/University: Dates attended:
Degree or Diplomas: Major(s):
*High School: *Dates attended:
Other Educational/Academic Experiences:

EMPLOYMENT HISTORY
Are you presently working in another department on campus? Yes No.
If yes, please list department(s):
Previous Tutoring Experiences -- list subject(s), dates, employer. (Leave blank if not applicable.)

Subject Dates Employer
1.
2.
3.

Other Employment -- list employer, position(s), dates. (Leave blank if not applicable.)

Employer Position Dates
1.
2.
3.


You may also attach a recent resume:
Anticipated Involvement in Campus/Work Activities Next Semester (include hobbies, clubs, organizations, other employment -- list membership and offices held):
* Check the courses you are able to tutor. You must have earned at least an A- in the course you intend to tutor. See the Undergraduate Bulletin or WCU's website (www.wcupa.edu) for course descriptions.
ACC-201 CHE-232 GER-102 MAT-110 PHY-180
ACC-202 CSC-110 GER-201 MAT-121 PSY-100
ANT-102 CSC-141 GER-202 MAT-151 PSY-245
BIO-100 CSC-142 GEO-101 MAT-161 PSY-246
BIO-110 ECO-111 HIS-150 MAT-162 RUS-101
BIO-230 ECO-112 HIS-151 MAT-Q00 RUS-102
BIO-259 ECO-251 MAT-101 MAT-Q01 SOC-200
BIO-269 ECO-252 MAT-102 MTC112-215 SPA-101
CHE-103 FRE-101 MAT-103 PHI-101 SPA-102
CHE-104 FRE-102 MAT-104 PHY-100 SPA-201
CHE-107 FRE-201 MAT-105 PHY-130 SPA-202
CHE-230 FRE-202 MAT-107 PHY-140 SPK-208
CHE-231 GER-101 MAT-108 PHY-170 WRT-120
Other courses:
Identify two faculty members in the area(s) in which you wish to tutor who can provide a recommendation. In addition, please have them complete one of the attached recommendation forms (PDF) and mail or fax the form directly to the LARC.
*Name: *Dept.: *Phone: - -
*Name: *Dept.: *Phone: - -

* I waive retain the right to view the recommendation.