Tutoring Registration Form for HELP Program

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Tutoring Registration Form for HELP Program

Fill out the following form completely in order to register for College HELP Program academic tutoring, Life Coaching, and/or Skill Development hours. There are also in-house paper forms in Myers Hall if you need assistance completing the form or need guidance.

This form and a $100 non-refundable deposit must be received one month prior to the start of the semester for which you are registering. Incomplete registrations and/or not submitting a deposit will result in a delay in processing and possibly a cancellation in tutoring hours. For deposit, see Brett Jones, Business Manager, Myers Hall 121; 304-696-5220; jones189@marshall.edu.

Remaining balances on all tutoring fees are due on the first day of the semester. If fees are not paid by this date, tutoring hours may be cancelled.

Basic Information

MUID Number

First Name:

Last Name:

Student Email

Student Phone

Street Address Line 1:

Street Address Line 2:

City:

State:

Zip:

Parent/Guardian 1 Name

Parent/Guardian 1 Phone

Parent/Guardian 1 Email

Parent/Guardian 2 Name

Parent/Guardian 2 Phone

Parent/Guardian 2 Email

Choose the semester in which you are registering

Fall

Spring

Summer A

Summer B

Summer C

Summer D

Skill Development Tutoring

Skills Development focuses on supporting students to enhance strategies and skills in areas of study skills, time management, organization, reading, writing, and/or math. Highly trained professionals meet with you weekly to ensure you create practical strategies and habits that will help you succeed in college and last a lifetime.

How many hours of skills tutoring per week would you like to sign up for?

Type of skills you hope to work on (check all that apply):

Study Skills

Time Management

Organization

Reading

Writing

Mathematics

List your preferred skills tutor(s) (if known):

Life Coaching

Life Coaching provides you with holistic supports in college based on YOUR goals. From organization and daily independent living skills to internship applications, our professional Life Coach will support you to achieve your collegiate aspirations.

How many hours of life coaching support per week would you like to sign up for?

Types of goals you have for life coaching:

Academic Tutoring

Academic tutoring is one-on-one instruction from a graduate level to professional tutor who will assist you to understand your course content, create study guides, outline papers, and more! They also set up all exam proctoring in Myers Hall to ensure you receive all necessary accommodations.

Please fill out the following fields with the course in which you would like to receive tutoring, the number of hours/week you would prefer, and a tutor's name (if known).

1. Course & Section Number (Ex. English 101-201):

Number of hours tutoring:

Preferred tutor (if known):

2. Course & Section Number (Ex. English 101-201):

Number of hours tutoring:

Preferred tutor (if known):

3. Course & Section Number (Ex. English 101-201):

Number of hours tutoring:

Preferred tutor (if known):

4. Course & Section Number (Ex. English 101-201):

Number of hours tutoring:

Preferred tutor (if known):

5. Course & Section Number (Ex. English 101-201):

Number of hours tutoring:

Preferred tutor (if known):

6. Course & Section Number (Ex. English 101-201):

Number of hours tutoring:

Preferred tutor (if known):

Financial Aid

I am a recipient of financial aid.

Yes

I am supported by The Division of Rehabilitation Services (DRS) and/or Vocational Rehabilitation (VR)

Yes

Please do your best to fill out your counselor's contact information as thoroughly as possible. But if you are unsure of any information, please just leave blank.

DRS/VR Counselor's First Name

DRS/VR Counselor's Last Name

DRS/VR Counselor's Email

DRS/VR Counselor's Address:

Street Address Line 1:

Street Address Line 2:

City:

State:

Zip:

I am a Marshall Student who is enrolled in:

The Marshall HELP Program

The College program for Students with Autism Spectrum Disorders

The Office of Accessibility and Accommodations (formerly the Disability Office)

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