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First Name
Last Name
Social Security
Address
City
State
Zip
Telephone #
Referred By
Date
Are you taking any courses on the Teaneck Hackensack
Campus?
Yes No
What is your Major
Year
Grad
Freshman
Sophomore
Junior
Senior
Areas in which you want help in:
Assigned:
I understand that the purpose of this contract is to establish
conditions which help me to succeed in my program of studies.
As a participant in this service, I agree to:
1. Attend sessions regularly. I understand that I am allowed a Maximum
of Two absences per semester per subject.
More than two absences per semester per subject will
result in cancellation of my tutorial privileges.
2. Meet all requirements of my courses. I will schedule time in
advance of a due date to work on any assignment which will
require advance preparation i.e papers.
By submitting this form I fully understand and intend to fulfill the
requirements.
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