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 the NHS Advisor at New Berlin Eisenhower.  You will receive a confirmation email shortly.  Thank you.

* Enter Your Email Address:

  

Last Updated: 9/27/12
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