Floridia A&M University

College of Pharmacy and

Pharmaceutical Sciences
CARE Tutoring Services
Please complete and return to the Community Outreach and Service Learning Office, 337 NPB.

Student Information
Date: Semester:
Name (Last, First, Middle Initial): Student ID#
Local Address: City: State: Zip Code:
E-mail Address:
Permanent Address: City: State: Zip Code:
Local Phone Number: Alternate Phone:

Focused Tutoring
Request for tutoring in the following course(s):

Course Name: Professor:

Course Name: Professor:

Course Name: Professor:

Describe the difficulty you are having with the course (s):

Retaking this class Low test scores

Lectures are hard to understand Overall low performance in class

Reading is hard to understand Uncertain of the Professor’s

expectations

Understand in class until it’s time to do homework Struggled in previous classes in this s
subject
Other (please specify)
Individual Tutoring Agreement
 I will attend tutoring sessions as scheduled. (initial)
 If I am unable to meet with my tutor, I will cancel a minimum of 24 hours in advance. (initial)
 I understand that if I miss two sessions without canceling 24 hours in advance, I am not be able to schedule
individual tutoring for the remainder of the month. (initial)
 I understand that if I am over 15 minutes late, I am considered a “no show”. (initial)
 I agree to complete evaluations of tutoring sessions as requested. (initial)
 I will come to tutoring sessions prepared with specific questions. I will bring my text and all pertinent materials. I
understand my tutor will not do my work for me. (initial)
Student Signature Date:

CENTER USE ONLY:

Date Received: Assigned Tutor: Approved for hrs/wk Start Date: