Peer Tutoring - Registration Form 2010

Subject Areas: Please indicate your preferred subject areas for tutoring in
First Name
Surname
Student Number
Date of Birth	Format: YYYY-MM-DD
Address
Telephone Home
Mobile
E-mail (Preferred method of contact)
	I access my e-mail regularly
Do you have your own transport?
Where did you complete your high school education?
Would you like to tutor at your old school?
If you have another preferred school please name it here

General Science (Yr 8-10)
Human Biology (Yr 11-12)
Biology (Yr 11-12)
Chemistry (Yr 11-12)
Physics (Yr 11-12)
Psychology
Physical Education
Computing (please indicate your computing strengths)
Availability: Please tick to indicate timeslots when you think you may be available to tutor.
	AM 9:00 - 12:00	PM 12:00 - 4:00
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY

Any other comments/queries
Do you have any medical conditions that may affect your ability to tutor in schools?