Tutoring Intake Form

Complete and submit the following tutor request for assistance in a specific subject or general study skills. You can request tutoring for up to 3 courses on one form. 

You will need to complete the Barsch Learning Style Inventory prior to requesting a tutor.  Please submit your results with your request. 

The LAC will contact you via your Xavier email about your tutoring arrangements.

Student Information

The ID number on your ALLCard that begins with "000"

Phone Number *

Have you previously requested tutoring services through the LAC? *

May we notify your professor about your tutoring? *

Course Information

  • If you are requesting a tutor for General Biology, General Chemistry, Organic Chemistry, or Anatomy & Physiology, you are strongly encouraged to attend the SI sessions for your course. A tutor may be assigned after you have regularly attended SI sessions.
  • At times, there can be a waitlist for tutoring services and working with another student may help minimize the time you are on the waitlist. Therefore, you may be paired with another student in the same course.

Tutoring Environment

Tutoring Environment

Tutoring Availability

Starting with tomorrow, please list the time slots that you are available for tutoring. Give as much availability as possible.

If today is Wednesday, fill out Thursday, Friday, etc. for when you’re available tomorrow and the days after. Complete Monday through Wednesday for when you are available next week.

Barsch Learning Style Inventory Results

Tutoring Agreement

 

I agree to come to my tutoring sessions prepared with books, notes, syllabus, and other class materials. I also agree to be prompt to my appointments, and will contact my tutor at least 24 hours in advance if I cannot make a scheduled appointment. I understand that I will be notified if there are any concerns about my attendance. The LAC staff has my permission to access my grades for records, and these grades will be kept confidential.

Check the "I agree" box to continue.