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    Ursuline Academy of Cincinnati
    Request for Peer Tutor
    Date:
    Student's
    First Name:
    Student's
    Last Name:
    Homeroom:
    Teacher's
    First Name:
    Teacher's
    Last Name:
    Subject:


    Please list specific problems student is having with class:


    Would you (the teacher) like to meet with the tutor first?
    Yes No


    Please list all the student's free mods and study mods:
    A day:

    B day:

    C day:

    D day:

    E day:

    F day:

    Student understands that by making this request she is making a committement to meet with a peer tutor once every cycle until the end of the semester:
    Yes No
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    Ursuline is my second home! I like the people here and the atmosphere. Ursuline gives off good vibes like warmth and friendliness.

    Greta '06, Student


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