Harvard-Westlake Tutoring

Request A Tutor

Name:
Grade:
Gender:	Female Male
Address:
Home Phone:
Cell Phone:
E-Mail Address:

What subject(s) do you want help with?
Subject:		Teacher:
Subject:		Teacher:
Subject:		Teacher:
When would you like the Peer Tutor to help you?

Day 1	Before School Which X Periods? After School?
Day 2	Before School Which X Periods? After School?
Day 3	Before School Which X Periods? After School?
Day 4	Before School Which X Periods? After School?
Day 5	Before School Which X Periods? After School?
Would you like to request a particular Peer Tutor? (see Bulletin Board at the end of the 2nd Floor Seaver hallway, past Mr. Salamandra's office)
Tutor Name: