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DUKE UNIVERSITY PEER TUTORING PROGRAM
Academic Resource Center
201 Academic Advising Center
Box 90694
684-5917  [email protected]
Section I: Employment Application
Applying for:  1-1 Tutor  Walk-In Tutoring  SAGE TA  Office
Date ____________________
 Summer I  Summer II  Fall/Spring
Name ______________________________
Class of ______ Year: Fresh, Soph, Junior, Senior, Grad
Phone ______________________________
School Address/Box ____________________________
GPA in your major ____________________
Major/minor __________________________________
Duke Unique ID ______________________
E-mail Address _________________________________
Are you on Duke payroll? Yes
If so, department & supervisor _____________________
Work-Study:
Yes
No
No
Ethnicity______________________________________
Date of Birth _______________________
I prefer to be called _____________________________
Tutoring Courses With a B+ Grade or Higher
Bio: 199D (Intro to Bio), 201 (Molecular Bio), 202 (Genetics & Evolution) – SAGE TA position
Chem: 101DL (Core), 110DL (Honors), 201DL (Organic), 202L (Organic)
CompSci: 101 (Intro to Computers), 201 (Data Struc/Algori)
Econ: 101 (Principles), 201D (Intermediate)
EGR: 103L (Computation Methods), 201L (Mechanics of Solids)
Physics: 141L (Intro to Mechanics), 142L (Intro to Electric), 151L (General), 152L (General)
Math: 105L (Calculus Funcs I), 106L (Calculus Funcs II), 111L (Calculus I), 112L (Calculus II), 122L (One Variable Calculus),
202 (Multivariable Calculus for Econ), 212 (Multivariable Calculus), 216 (Linear Algebra/Diff Equation)
Foreign Languages (Native Speakers Only): ______________________________
Subjects and Courses you are
able to tutor (list in order of
preference):
Semester Taken
Instructor
Grade
1. _________________________
_______________
________________
______
2. _________________________
________________
________________
______
3. _________________________
________________
________________
______
4. _________________________
________________
________________
______
5. _________________________
________________
________________
______
6. _________________________
________________
________________
______
How did you hear about this position? (check all that applies)
____ Participant
___ Instructor
____ Friend ____
Posting Flier ____ DukeList
____Website ____ Recruited by Peer Tutoring Coordinator Other:__________________________
Can you commit to working four hours a week? ____ yes
____no
If no, please explain:
Share any previous experience (paid or volunteer) that qualifies you for this position:
What interest, if any, do you have for extensive learning/teaching/education training? Please give examples:
US Citizen: Yes
No
Permanent Home Address:
____________________________________
____________________________________
GRADUATE STUDENTS ONLY
Undergrad college _________________________________________ Major___________________
Marital Status: Single Married Separated Divorced
Do you hold another campus position? Yes No
If yes, are you:
 Paid monthly - on the 25th of the month
 Withholding exempt? - paid on the last day of month
 Bi-weekly – paid twice a month
Signature
I certify that all the information contained in this application is true, accurate, and complete. I
understand that making false or fraudulent statements in this application may result in the termination
of my employment.
Signature___________________________________________ Date______________________
Section II: Walk-In Tutoring - Applicants (Fall & Spring only)
Can you commit to a 3 hour work shift? ___ yes __ no If no, please explain:
Indicated the days that times that you are available to work:
COURSE
Chemistry 101DL
Chemistry 201DL
Chemistry 202L
Econ 101
tba
DAY
TIME
I Can Work This
Shift (check)
LOCATION
Sunday
2-5pm
Physics 047
Tuesday
7-10pm
Physics 047
Thursday
7-10pm
Physics 047
Sunday
2-5pm
Bio Sci 113
Tuesday
7-10pm
Bio Sci 113
Thursday
7-10pm
Bio Sci 113
Sunday
2-5pm
Bio Sci 144
Tuesday
7-10pm
Bio Sci 144
Thursday
7-10pm
Bio Sci 144
Sunday
2-5pm
Physics 205
Tuesday
7-10pm
Physics 205
Thursday
7-10pm
Physics 205
Sunday
2-5pm
Carr 136
Tuesday
7-10pm
Carr 136
Section III: PEER TUTORING PROGRAM
INSTRUCTOR RECOMMENDATION
Date ___________ Potential Tutor ____________________________ Course(s) ___________________
Portion Below Is To Be Completed By Instructor
Name____________________________________
Title______________________________________
Department_______________________________
Address/Box_______________________________
Phone___________________________________
Email_____________________________________
1)
I recommend this student as a tutor for ____________________________________.
 without hesitation
 highly
2)
This student has taken the following course(s) with me:
3)
I consider him/her to be:
 a model student
 works well with others
 with reservations
 was not a good student
 I do not remember him/her.
OR
 While the potential tutor has not done any course work with me, I know of his/her work
(please state how or why) and endorsement to him/her as a tutor.
Instructor Signature _____________________________________
Date ____________________
Return to:
Monique Harris, Peer Tutoring Program Coordinator
Academic Resource Center
211 Academic Advising Ctr. Bldg, Box 90694
Phone: 919-684-5917 Fax: 919-684-8934 Email: [email protected]