Student Information Sheet

82-281             Tutoring for Community Outreach

 

Name _________________________________________________

 

Email ___________________Phone number____________________

 

Major/Minor ____________________________________________

 

Class __________________________________________________

 

Current QPA ____________________________________________

 

Language preference(s) _____________________________________

(Please indicate if you are willing to work with students of ESL as well.)

 

Your reasons for wishing to take this course:

______________________________________________________

 

______________________________________________________

 

______________________________________________________

 

______________________________________________________

 

Highest level language class taken ______________________________

 

Modern Languages faculty reference(s)___________________________

 

Number of units you wish to earn (6 or 9) ________________________

(To earn 6 units, you should spend 4 hours in a school plus complete the other activities indicated on the course syllabus. To earn 9 units, you should spend 6 hours in a school plus complete the other activities indicated on the course syllabus.)

 

Site preference (elementary, middle school, high school) ______________

 

(If you have been working at a particular school, please indicate which one.):

____________________________

Please indicate if you can attend a weekly meeting on campus:

Mondays, 3:30-4:20   YES______                 NO ______

 

Please complete the second side of this sheet and return to the mailbox of the faculty liaison.


Hours available

 

Indicate with an X the hours you are available to work at the school site.

Name:_____________________________

Elementary School Schedule:

Figure on one half hour at each end for transportation between campus and your school site.)

                                                             M          T          W        R         F

Period 1           9:10-9:53                     ___      ___      ___      ___      ___

            2          9:53-10:36                   ___      ___      ___      ___      ___

            3          10:36-11:19                 ___      ___      ___      ___      ___

            4          11:19-12:06                 ___      ___      ___      ___      ___

            5          12:08-12:55                 ___      ___      ___      ___      ___

            6          12:57-1:44                   ___      ___      ___      ___      ___

            7          1:46-2:29                     ___      ___      ___      ___      ___

            8          2:29-3:12                     ___      ___      ___      ___      ___

High School Schedule

Figure on one half hour at each end for transportation between campus and your school site.)

                                                             M          T          W        R         F

Period 1           7:30-8:11                     ___      ___      ___      ___      ___

            2          8:16-8:57                     ___      ___      ___      ___      ___

            3          9:02-9:45                     ___      ___      ___      ___      ___

            4          9:48-10:29                   ___      ___      ___      ___      ___

            5          10:34-11:15                 ___      ___      ___      ___      ___

            6          11:20-12:01                 ___      ___      ___      ___      ___

            7          12:06-12:47                 ___      ___      ___      ___      ___

            8          12:52-1:30                   ___      ___      ___      ___      ___

            9          1:30-2:19                     ___      ___      ___      ___      ___