Yellow or Green Record Sheet for the Shepherd University Academic Support Center

Circle One: Fall / Spring of the Year _____________

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Student’s Last Name First Name SU Email Address

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For which class are you requesting tutoring? What is your teacher’s name?

Location: 114 Other?

Date:

Tutor :

Tutor’s Notes on the Session: Be sure to discuss CONTENT, METHOD, STUDENT AFFECT & FUTURE PLANS

Duration of Session:

Please Continue on the Back -- Last Updated 8/22/06