Docstoc

APPLICATION FOR TUTOR SERVICES

Document Sample
APPLICATION FOR TUTOR SERVICES Powered By Docstoc
					Instructions:

1. Find a tutor recommended by your professor or TA.
2. Fill out the tutor request form.
3. Ensure your tutor signs and dates the request form.
4. Bring request for to your student advisor.

Once approved by the Commanding Officer, your NROTC funded
tutoring can begin. Log all

5. Log all tutoring hours on the record sheet.
6. Give the record sheet to the Supply Officer for payment.




NROTC-UCB Form TF1 (Enclosure 1)                     Revised 14 JUL 03
Contract for Tutor Services Rendered

          This is to certify that I, ___________________ (hereafter referred to as student), am receiving

tutor services from _________________________ (hereafter referred to as tutor). The fee will be

fixed at $__________ per hour. The student will be tutored for approximately ______ hours a

week, totaling $___________ per week for the time period between ________________ and

________________. Payment obligations will be fulfilled by NROTC Unit UC Berkeley on a

monthly basis. Billing will be submitted using NROTC-UCB Form TF1 (Enclosure 1) by the

tutor via monthly invoice to:

NROTC UC Berkeley
ATTN: Tutor Services
152 Hearst Gym
Berkeley, CA 94720



Privacy Act Notification: Pursuant to Privacy Act, 5 U.S.C. Sec. 552, the requested information will not be divulged without
your written authorization to anyone other than personnel involved with administration of NROTC activities. Disclosure is voluntary,
however failure to provide the requested information may preclude submission of services on this form.




____________________________                                 ___________________________
Student                 Date                                 SSN




____________________________                                 ____________________________
Tutor                   Date                                 SSN



____________________________
Commanding Officer      Date




NROTC-UCB Form TF1 (Enclosure 1)                                                                Revised 14 JUL 03
   APPLICATION FOR TUTOR SERVICES
Instructions: Complete and submit form to Supply Officer. Please Print

 Name: Last                                    First, MI                                   Date of Submission:

 SSN:                                          DOB: (MMDDYYYY)                             Rank:

 School:                                       College:                                    Major:


 Course Tutored:                             Date:             Hours Tutored:           Daily Rate:            Daily Total:




 Total:

Privacy Act Notification: Pursuant to Privacy Act, 5 U.S.C. Sec. 552, the requested information will not be divulged without
your written authorization to anyone other than personnel involved with administration of NROTC activities. Disclosure is voluntary,
however failure to provide the requested information may preclude submission of services on this form.

 DATE:                     PRINTED NAME OF TUTOR                                      SIGNATURE OF TUTOR


 DATE:                     PRINTED NAME OF STUDENT                                    SIGNATURE OF STUDENT


 DATE:                     PRINTED NAME OF ADVISOR                                    SIGNATURE OF ADVISOR


 DATE:                     PRINTED NAME OF APPROVING OFFICER                          SIGNATURE OF APPROVING OFFICER




NROTC-UCB Form TF1 (Enclosure 1)                                                                Revised 14 JUL 03

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:8
posted:10/6/2011
language:English
pages:3