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Tutor Request Form

To request a tutor, please fill in the fields below. GREEN fields are required.

Please fill out the form completely in order for us to select a tutor that best matches your needs.

Once you are paired with a tutor, we will request payment information and email a confirmation of the schedule, including details about your tutor. 



Student's First Name:
 
Student's Last Name:

My relationship with
the student: 
 


If you are not the student, please provide your first and last name.
First Name:
 
Last Name:
 
Street:
 
City:
 
State:
 
ZIP:
 
Mailing Address:


Email Address:
 
Primary Phone:
 
Secondary Phone:
 
 
Student's School:
  
Grade Level: 


For which subject(s) are you requesting tutoring?

Subject 1:
  
Current Grade: 
 


Select a preferred start date on the calandar.

  ->
S M T W T F S


How many days each week do
you want tutoring?
 
Approximately how many hours do you want each session to last? (We have a "one-hour minimum" policy.)
 
Do you prefer that tutoring sessions occur on weekdays, weekends, or both?


Which three days do you prefer most to hold your tutoring session(s)?

Sundays Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays



Select the reason(s) for seeking tutoring.

Maintaining Grades Improving Grades Greater Conceptual Understanding Confidence Building Other



What type of tutor do you prefer?
 
How did you learn about Rice Tutors?
 


Include any additional comments below.




Please review your information to ensure its accuracy before submitting.


 
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