ENTER YOUR INFORMATION BELOW AND SUBMIT THE FORM

Name

Last Name     

First Name    

Middle Name 

 

Present Address

Street Address

City State Zip Code

Your Phone Number

Your Email Address 

Permanent Address

Street Address

City State Zip Code

Social Security Number

MUID NO. (If different) 

Birth Date (MM/DD/YYYY)  Sex  Female Male

Residency Status (check one)  Resident  Metro  Non-Resident
 

 

Academic

Current Institution

Institution

Date Attended from to (MM/DD/YYYY)

Type of degree (eg: B.A., B.S., M.A., M.S. )

Major  Minor

Date Received/ Expected (MM/DD/YYYY)

Cumulative GPA No. hours you wish to take in next semester

Previous Institution

Institution

Date Attended from to (MM/DD/YYYY)

Type of degree (eg: B.A., B.S., M.A., M.S. )

Major  Minor

Date Received/ Expected (MM/DD/YYYY)

Cumulative GPA

No. hours you wish to work per week (Must be 10 or 20; 20 is full-time G.A.)

Date you will be available for employment

 

Working Experience

Title or Rank

 

    

Employer

 

    

Years

 

Academic Honors and Awards.

Do you have any experience in tutoring? Yes  No

If so, please describe it.

Have you been previously employed by Marshall University? Yes No

References: Please give reference forms to two people who know you and return them to H.E.L.P.

 

Please list courses, which you feel qualified to tutor.

Please refer to the class schedule for Marshall University. Please list specific courses.

 

 

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