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Tutee:
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Tutor:
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Subject:
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Semester:
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Date:
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1. Was your student prepared for the tutoring
session? Yes No
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If your response is no, please explain.
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- Had
she/he completed her/his assignments for class, as well as any
assignments made by you? Yes
No
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If your
response is no, please explain.
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- How
is your student’s attitude toward his/her chances of successfully
completing this class? Please
check one.
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Very Positive Average Negative Could Care Less
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Tutor Signature
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Date
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Academic Coordinator Signature
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Date
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Tutee Contact Date: _____________
By: _________________
Tutor Contact Date: _____________
By: ________________
Professor Contact: Date: _____________
By: ________________
Notes: