Upward Bound Tutor Application Name * First Last Student ID # School Mail Box # Home Address Street Address Address Line 2 City State / Province / Region Postal / Zip Code United States United Kingdom Australia Canada France New Zealand India Brazil ---- Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Democratic Republic of the Congo Republic of the Congo Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faroe Islands Fiji Finland Gabon Gambia Georgia Germany Ghana Gibraltar Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles Nicaragua Niger Nigeria Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Country Phone Number * ### - ### - #### SHU Email * Alternate Email SHU STUDENTS If you are not a SHU student, skip this section and proceed to TUTORING SUBJECTS sections Are you a full-time or part-time student? Full-time Part-time What is your major field of study? What is your minor field of study? Do you receive any type of financial aid? Yes No If yes, please list what type(s) Does your package include workstudy? Yes No If yes, what is the amount of your workstudy award for the semester? If you already have a workstudy position, please list the department you are currently working in TUTORING SUBJECTS Check the subjects(s) you are interested in tutoring. Remember you must have at least a 3.0 GPA in the specified subject area(s) Check All That Apply English History US European Math Algebra Geometry Calculus Trigonometry Science Physical Biology Chemistry Physics Spanish Level I Level II Level III Other DAYS YOU ARE AVAILABLE TO TUTOR We only tutor after regular high school hours which are Monday - Friday, 2:30 - 3:30 PM and bi-monthly on Saturdays from 9 AM - 12 Noon Check off all available days * Monday, 2:30 - 3:30 PM Tuesday, 2:30 - 3:30 PM Wednesday, 2:30 - 3:30 PM Thursday, 2:30 - 3:30 PM Friday, 2:30 - 3:30 PM Bi-Monthly Saturday, 9 AM - 12 Noon Do Not Fill This Out
