Tutee Request Form General Information

Tutee Request Form General Information

Tutee Request Form General Information

Tutee Request Form General Information

  • Date: Date: * / /
    Pick a date.
  • Name: Name: *
  • Telephone: Telephone: * - -
  • Contacts from the Tutoring Office will be through your telephone or MU E-mail

  • Are you a student registered with the Office of Learning Services (learning or physical disability)? *
    Are you a student registered with the Office of Learning Services (learning or physical disability)?
  • Are you an MSP student? *
    Are you an MSP student?
  • Counselor Name: Counselor Name:
  • Are you a Student Athlete? *
    Are you a Student Athlete?
  • Coach Name: Coach Name:
  • Class Information

  • If available, do you prefer: *
    If available, do you prefer:
  • Tutee Agreement


    I have read and I understand the procedures and responsibilities of a tutee receiving services from the Millersville University Tutoring Center through the Office of Learning Services. I agree to adhere to these procedures and responsibilities, and I understand that failure to do so may result in my tutor being assigned to someone else and my having to reapply for a tutor.

    I understand that my responsibility as a tutee is to attend scheduled tutoring sessions and bring course materials and specific questions or problems. I understand that my tutor may not do problems, reports, or other assignments for me.

    I understand my contact information will be released to my tutor in order to begin my tutoring sessions.

    I understand that all tutoring sessions are to be conducted in a public place, such as the library, and may not be conducted in a residence hall room, apartment, or home.

    I understand that the tutor-tutee relationship is a confidential one, that information regarding the tutor, including but not limited to, phone number, e-mail address, and local address, is to remain confidential, not to be disclosed to anyone outside the Tutoring Center Office unless authorized to do so by the tutor. I also agree not to use the tutor’s personal information for any use other than tutoring. Failure to maintain confidentiality may result in the termination of tutoring services.

    I understand that if I have questions or concerns about the above procedures and responsibilities, I should contact one of the Tutoring Center Graduate Assistants at 717-871-7222.

  • Draw or Type
    I understand this is a legal representation of my signature. Clear