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Please provide us with the following information:
Today's Date (DD/MM/YYYY)
First Name
Last Name
UWGB email
Cell Phone #
Major
Minor
Year in school
FR
SO
JR
SR
Other
Are you in a First Year Seminar?
Yes
No
Are you a transfer student?
Yes
No
Are you enrolled in Gateways to Phoenix Success?
Yes
No
Please list the course prefix, number/sec, title, and the instructor’s name for the course. This information can be found on your schedule or the course syllabus. If unsure, look it up in SIS.
Course Prefix (Example) ACCTG 300-0001
Title (Example) Intro Accounting
Instructor (Example) Prof Smith
Have you ever used our services prior to this semester?
Yes
No
How many times have you requested help from the professor of the class:
0
1
2+
How many hours do you spend outside of class each week preparing for this class?
Less than 2
2
3
More than 4
Do you have well-organized notes of your own from the class?
Yes
No
Briefly, tell us how you learn or what you would say is your “best” way to learn. (You can pick more than one answer)
I need to see examples
I like to have things read to me
I like to teach concepts to other people
I like to work with others
I like to do hands on repitition
I like to go through examples of practice problems or homework questions
I like to talk about the concepts
I like to go through my notes
How did you hear about The Learning Center services?
A professor told me
The Learning Center website
During Green Bay Orientation or Welcome
From a syllabus
From my peer mentor or TA
From a friend
Other
*I UNDERSTAND THIS REQUEST DOES NOT GUARANTEE THAT A TUTOR WILL BE AVAILABLE BASED ON SCHEDULES AND STAFFING CHANGES (PLEASE INITIAL)
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