Instructor's Name:
*
First Name
Last Name
Email:
example@tmcc.edu
Service(s) Requested:
*
Supplemental Instruction (SI)
Embedded Tutoring (ET)
Semester:
*
Spring
Summer First Session
Summer Second Session
Fall
Winter
Dynamic
Course Name:
*
Course Section:
*
Class Meeting Dates:
*
Class Meeting Days:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Class Meeting Times:
*
Preferred Tutor:
Additional Comments:
Certification and Acknowledgment
By pressing submit, I verify that I've read through and agree to the roles of the embedded tutor.
Please verify that you are human:
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Sender Name:
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