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Math Center Tutoring Referral Form
Student Information
Today's Date:
Student ID #
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(Seven-digit student ID number)
First Name
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Last Name
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Email
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Math Course Information
Math Class
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-Select one-
Math 85
Math N06
Math N48
Math 060
Math 070
Math 080
Math 081
Math 083
Math 084
Math 087
Math 105
Math 140
Math 150
Math 160
Math 167
Math 170
Math 180
Math 185
Math 204
Math 280
Math 287
Other
If Other, please specify:
Class Section #
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Instructor Name
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To help you improve your skills and comprehension in this course, you are advised to seek a tutor’s assistance in the Math Center (L-204). In accordance with Section 58170 of Title 5 of the California Code of Education, all students receiving tutorial services may only receive those services “after referral by a counselor or an instructor on the basis of an identified learning need.” Students who receive tutoring will automatically be enrolled in a noncredit course that is free of charge. In order to use the Math Center, I agree to be enrolled in a free, non-credit class called Supervised Tutoring which allows you to use the Math Center. The “BS SUPERVISING TUTORING” class will appear in your WebAdvisor.
DO NOT DROP THIS CLASS
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