NHS Tutor Request Form

Tutor Request Form:

Please fill out the following completely.  Every effort will be made to fill requests in the order they are received.
*

Student Name
*

Grade
7   8   9   10   11   12
*

Student telephone number(s), include home and cell if possible.

Student email
*

Tutor requested for the following subject(s):  please include teacher name also
*

Student availability during the school day:

 (1 required)
HS 1   Core Block 1
HS 2   Core Block 2
HS 3   Core Block 3/4
HS 4   Core Block 5
HS 5   Core Block 6
HS 6A   Core Block 7/8
HS 6B   Before School 6:45-7:15 AM
HS 7   After School 2:30-3:30 PM
HS 8

Day of week preference (if any):
Monday   Tuesday   Wednesday   Thursday   Friday

Please include any additional information you feel would be helpful:

This form will be automatically forwarded to Mrs. Donlin, NHS Advisor at New Berlin Eisenhower.  You will receive a confirmation email shortly.  Thank you.

* Enter Your Email Address:

  

Last Updated: 1/6/12
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