Academic Success Tutor Request Form

Please complete and submit the following form to Academic Success at Worcester State University.

* First Name:
* Last Name:
* Best Phone #:
* Campus Status:  
* Class Rank:  
* WSU Email:
* Major:
* Course Number:
* Course Name:
* Professor's Name:
* Grade Thus Far:
* Date of Next Exam:

What do you see as the underlying problem?

Would you like to request a certain tutor?  Please list their name in the following box. 
(Please keep in mind your availability below must match your requested tutor's availability)

Times Available: Mon (8am - 6pm)

Tues (8am - 6pm)

Wed (8am - 6pm)

Thurs (8am - 5pm)

Fri (8am - 5pm)

How did you hear about tutoring at Worcester State University?