H.E.L.P. Registration Form

Registration form for Spring Semester 2014

Registration form must be submitted and deposit must be returned by January 2nd, 2014. All fees due by January 13th, 2014

All students must complete the form. Tutoring assignments will not be made until form is completed.

Student's Name

Last Name      First Name   

Student email Address    MUID

Billing Name (Parent)  

Billing Address    Zip Code

Father's Work Phone Mother's Work Phone  

Home Telephone   Parents' e-mail Address

Tutoring Needed in the  following classes 

Tutoring hours requested for each class

Preferred tutors                         (optional)

If SKILLS DEVELOPMENT tutoring is required as a condition of your acceptance, it will be added to your tutoring hours. If you are a continuing student or a new student who wishes to take SKILLS DEVELOPMENT tutoring, please enter the desired number of hours of SKILLS DEVELOPMENT tutoring in the box.



$200 WV resident

$200 Metro

$300 Non-resident

Student is a financial aid recipient.

Student is a client of vocational rehabilitation.  Send copy of this form to VR counselor.





We will observe this request whenever possible.