Student Success Center

Peer Tutor Application

Please complete & submit application to Jana Carlson in the Clarke M. Williams Student Success Center. Complete
application includes the faculty Recommendation Form on page 5. The application will not be accepted unless all 5 parts
are completed. The Recommendation Form needs to be in a separate sealed envelope.

Application Requirements:
1. Must have earned a “B” grade or better in the course(s) you wish to tutor.
2. Must have attended ULM full time for at least one semester.
3. Must have taken the coursework you wish to tutor at the university in the U.S.A., preferably ULM.
4. Must be enrolled in at least 6 credit hours.
5. Must be a mature, responsible individual dedicated to helping others achieve academic success.
6. Must possess strong communication skills.

Application is for (Semester/Year): _____________________ Date: _________________

PART ONE
Applicant Name
First Name
Middle Name/Initial
Last Name
Preferred Name
CWID

Local Contact Information

Street
City, State, Zip
Home phone
Cell phone
Email

Permanent Address
Street
City, State, Zip

Education
Major
Classification
Hours Earned
Cumulative GPA
Sem.&Year of Grad.

Have you tutored before? Yes No

If yes, when & where? ____________________________________________________________

PART TWO

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Check the courses that you are interested in tutoring and note that we tutor only math and sciences. The more classes you
are interested and able to tutor in, the better. Check as many courses as possible.

MATH 0093 (Developmental Math) BIOL 1001 (The Living World)

MATH 1011 (College Algebra) BIOL 1014 (intro A&P I)
MATH 1012 (Trigonometry) BIOL 1015 (intro A&P II)
MATH 1013 (Pre-Calculus) BIOL 1020 (Principles I)
MATH 1014 (Applied Calculus) BIOL 2014 (Intro Micro)
MATH 1016 (Elementary Statistics) BIOL 2020 (Cell Biology)
MATH 1018 (The Nature of Math) BIOL 2026 (A&P)
MATH 1031 (Calculus I) BIOL 2028 (Pathophysiology)
MATH 1032 (Calculus II) CHEM 1001 (Intro I)
PHYS 2003 (General I) CHEM 1002 (Intro II)
PHYS 2004 (General II) CHEM 1007 (General I)
PHYS 2007 (Mechanics,Sound,Heat) CHEM 1008 (General II)
PHYS 2008 (Electricity,Magnetism,Light) CHEM 2030 (Organic I)
CHEM 2032 (Organic II)
Other Math/Science_____________________

Please list all relevant coursework.

Course Name Course # Grade Received Professor Where Taken When Taken

*If you need more space, just write underneath.

PART THREE
List the times you are available to tutor. If you are unsure of the available work hours, leave it blank. Be aware that the
SSC tutoring hours are Mondays-Thursdays 10 a.m. to 8 p.m.
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 MONDAY TUESDAY WEDNESDAY THURSDAY

TIMES YOU ARE AVAILABLE

PART FOUR
Please briefly respond to the following 5 questions (PRINT CLEARLY):

1) How would you describe the role of a tutor?

2) Have you participated in other experiences that are relevant to the responsibilities of this position?

3) What is your definition of academic success?

4) What advice would you give to another student on how they can be more successful in the classroom?

5) The SSC Tutoring Center’s primary goal is to “foster independent learning.” What do you think this goal means?
How would you foster the independent learning of your students?

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PART FIVE
Please list the contact information for 3 ULM faculty references, who know the quality of your work.*** Please have in
mind that since we offer tutoring in math and sciences, it is necessary to submit references from at least 2 math and/or
science faculty members.

Name
Title
Phone
Email

Name
Title
Phone
Email

Name
Title
Phone
Email
***Please ask one of these three faculty references to fill out the Recommendation Form on page 5. Recommendation Form
should be completed by math/science faculty.

Thank you for your application!

You’ll be contacted to schedule an interview if your application meets the criteria and we have positions
available.

Submit application to Jana Carlson in the Student Success Center.

Your application will not be considered unless the Recommendation Form in a separate sealed envelope is
attached.

If you have any questions, please contact Jana Carlson at carlson@ulm.edu

Student Success Center

Peer Tutor Faculty Recommendation Form
Note to Faculty: Please return the form to the applicant in a sealed envelope with your signature across the seal. The
applicant will turn in this Recommendation Form along with his/her Peer Tutor Application. Thank You!

____________________________________________________ __________________________
Name of Tutor Applicant Subject

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____________________________________________________ __________________________
Name of Recommender Position

How long have you known the applicant? ___________________________________________________

In what capacity have you known the applicant? ______________________________________________

Please rate the applicant in the following areas. Base your ranking in comparison to other students.
Below Above
Unknown Average Superior
Average Average
Subject Knowledge- Grasps subject matter.

Communication- Articulates the concepts

necessary to explain the subject and effectively
express his/her ideas.
Professionalism- Demonstrates responsibility and
dependability. Is diligent and self-motivated.
Interpersonal skills-Displays ability to relate to
other students, builds rapport, and expresses
cultural sensitivity.

Please elaborate on the applicant’s strengths or potential weaknesses as they relate to tutoring.

Additional Comments:

Do you recommend this student to be a tutor? Yes No

Signature: ____________________________ Date: _____________

If you have any questions or comments, please contact Jana Carlson or call 342-3667.

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