(* Required)  
Application Date (mm/dd/yy)

Personal Information
First Name *

Last Name *

Middle Initial

Date of Birth (mm/dd/yy)

Student ID

Contact Information
Local Address

Local Address (cont.)

City

State

Zip/Postal Code

Mansfield e-mail *

Academic Information
Major

Current Year Please Select...FreshmanSophomoreJuniorSenior
Tutoring Information
Number of Hours per Week Available to Tutor

Specify the days and times you are available to tutor
Monday

Tuesday

Wednesday

Thursday

Friday

To tutor a course, you must have had a grade of B or better in that course. Course must be listed by department and course number (i.e. MA 1115).
Courses you are eligible to tutor:
Have you tutored before? *   Yes
  No
If yes, Number of Semesters:

List experiences and personal attributes that qualify you to tutor:

You will also need to submit 2 letters of reference from Mansfield University faculty to Ellen Hale (145 South Hall).