Jacbetti Center Office 103 Jacbetti TUTOR APPLICATION Recmmended by Faculty: Name: Address: NMU Student Number: Declared Majr: Date: Phne: E-mail: NMU GPA: STATUS (circle ne): Freshman Sphmre Junir Senir Graduate COURSES AND AVAILABILITY: Please indicate the curse(s) yu are qualified t tutr: AMT IM BI 104 OR 201 IT CN MA COS MET CRT MF DD OC 080 ET PH HM PT HN 210 WD HV WT 161 Please indicate the times yu are available t tutr: DAY A.M. P.M. MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 1
Name: EMPLOYMENT HISTORY: Emplyer: Address/Phne: Duties: Emplyer: Address/Phne: Duties: Are yu currently wrk-study eligible? YES NO Have yu previusly been emplyed n NMU s campus? YES NO If YES, please list where: REFERENCES: Please prvide the names and cntact infrmatin fr at least tw references: I understand that tutring is arranged based n student demand. If a tutring request matching my qualificatins is made, I will be cntacted. Otherwise, my applicatin will be kept n file until such a request is made. If I n lnger wish t be cnsidered fr a tutring psitin, it is my respnsibility t cntact the Tutr Crdinatr. Nrthern Michigan University endrses the intent f all federal and state laws created t prhibit unlawful discriminatin. Nrthern Michigan University des nt unlawfully discriminate n the basis f race, clr, religin, sex, natinal rigin, age, height, weight, marital status, familial status, handicap/disability, sexual rientatin r veteran status in emplyment r the prvisin f services, and prvides, upn request, reasnable accmmdatin including auxiliary aids and services necessary t affrd individuals wit disabilities an equal pprtunity t participate in all prgrams and activities. Persns having civil rights inquiries may cntact the Equal Opprtunity Office at (906) 227-2420. Persns having inquiries regarding the Americans with Disabilities Act (ADA) may cntact the ADA Crdinatr at (906) 227-1704. APPLICANT SIGNATURE: 2
Jacbetti Center Office 103 Jacbetti TUTOR CONTRACT I, the undersigned, understand and agree t the fllwing cnditins f emplyment by the Academic and Career Advisement Center Jacbetti Center Office: I understand that I am hired t assist students by helping them t understand curse material and t learn gd study habits I am nt hired t d the students hmewrk. I will nly be paid fr tutring thse students pre-apprved by the Academic and Career Advisement Center. I understand that the Academic and Career Advisement Center cannt and des nt guarantee the amunt f hurs I will wrk. I understand that I am limited t tutring 10 hurs per week. The rate f pay fr tutring is per hur, nt hper student. I am respnsible fr filing biweekly reprts f hurs wrked, students tutred, and material cvered. Tutring sessins are t be held n campus (in a lab, the library, r the Jacbetti Center Cmmns Area). If I am unable t make a tutring appintment, I will ntify either the student r the Academic and Career Advisement Center f my absence. Failure t d s will result in my dismissal. I understand that I am t ntify the Tutr Crdinatr f any prblems I am having with my tutee, and f any changes in tutring arrangement. I have read, understd, and signed the attached Buckley Amendment frm. I agree t cmplete and submit an evaluatin f the tutring prgram at the end f each semester fr which I ve been emplyed as a tutr. TUTOR SIGNATURE: DATE: 3
Jacbetti Center Office 103 Jacbetti CONFIDENTIAL INFORMATION Any recrds invlving student r emplyee infrmatin, private crrespndence and memrandums, and student financial infrmatin all f these (and mre) fall under the cnfidential categry. When wrking with such material, be certain that yu never leave yur desk r wrk area withut securely stwing away all dcuments r papers in a safe place. Never leave them sitting ut n yur desk while yu are gne fr lunch r a cffee break. The same rule f cautin hlds true fr prtecting the security f NMU s mainframe cmputer system and any passwrd(s) yu use t gain access t it. If a situatin arises cncerning cnfidential material, and yu are nt sure hw t respnd, get yur supervisr s advice n the matter immediately. As a rule f thumb, REMEMBER THAT IT IS ALWAYS BETTER TO ERR ON THE SIDE OF CAUTION. The fllwing directry infrmatin is cnsidered t be a matter f public recrd, and will be disclsed withut prir cnsent unless the student specifically bjects in writing: Name f student; Student s lcal address; Student s lcal phne; Student s permanent address; NMU email address; Date f birth; Whether r nt the student is currently enrlled; Enrlled full time/part time; Prgram level (undergraduate, graduate); Class (freshman, sphmre, junir, senir); Majr/minr; Dates f attendance; Current term candidacy fr degrees and/r teaching certificatin; Hnrs, degrees earned, and relative dates; Participatin in fficially recgnized University activities and sprts; and Weights and heights f athletic team members. ACAC Revised: August 29, 2001 4
BUCKLEY AMENDMENT By signing belw, I verify that the Family Educatinal Rights and Privacy Act f 1974 (the Buckley Amendment) has been explained t me. I agree that I will access cnfidential infrmatin nly as part f specific jb-related activities. Furthermre, I agree t bserve the cnfidentiality f all student infrmatin t which I am expsed in the curse f my emplyment, discussing it neither in general nr in specific with anyne (even ther students wh may have access t similar infrmatin) unless specifically instructed t d s by my supervisr. Such cnfidential infrmatin includes but is nt limited t: Student grades; Academic Prficiency status; Financial Aid status; Cnduct/Student Cde vilatins; Academic Transcript Infrmatin. I understand that a vilatin f cnfidentiality is grunds fr immediate terminatin f emplyment. Tutr Signature: Date: 5