Tutor-Mentor Program
Office Use Only
____ Distribution List
Center for Intercultural Learning and Community Engagement
____ Database
Murray Herrick Center 153
tutormentor@stthomas.edu
(651) 962-6466
Student Application
DUE DATE: September 24th by 4:00pm
Please drop off completed applications in MHC 153 or MHC 159
Applicant Information (Please Print)
Name:
Phone Number:
(
)
-
Cell Phone Number: (
)
-
Email Address:
Year in School:
First Year
Sophomore
Junior
Senior
If completing for credit, list course name AND professor:
** Application must be approved and signed by course professor prior to submission.
Also, if tutoring for class credit, YOU ARE RESPONSIBLE FOR FULFILLING YOUR CLASS REQUIREMENTS!!
Placement Questions
Would you have transportation to and from a site?
YES
Are you willing to drive a carpool of students?
YES
NO
Have you participated in the program before?
YES
NO
Have you completed VIRTUS Training?
NO
YES
NO
** All new and returning tutors are now required to attend orientation! Check your email for orientation dates and times; these will be held during the
third week of classes.
If you have a preference on your site placement, please list:
Grade Preference: (We will try our best to accommodate!)
K-3
4-6
7-8
Subject Preference:
Are you willing to tutor-mentor in an after school program? (May include enrichment and physical activities.)
YES
NO
Are you willing to tutor-mentor a non-English speaking student (English Language Learner)?
YES
NO
If you are fluent in any foreign languages, please list:
Availability:

LIST At least TWO time slots (at least 2.5 hours each) next to each available day!
 Times between 7:30a.m. – 6:30p.m.
 Morning and afternoon times (times over the noon hour are difficult to accommodate)
 Travel time should be incorporated in to your available time slot
** Your chances of being placed according to your preferences are higher if you list ALL available times and days.
Monday:
Tuesday:
Wednesday:
Thursday:
Times:
Times:
Times:
Times:
Faculty Use Only
Faculty signature verifies that the application reflects the specific course requirements:
(Faculty Signature)
** All special requirements (i.e. specific site, grade level, teacher, etc.) must be approved through
Tutor-Mentor Director, Kate Caffrey. Contact her directly at kdcaffrey@stthomas.edu or (651)962-6466.
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