Study Buddy Partnership Program Enrollment Form

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I am taking classes at University Park *

As a pilot program we must limit Study Buddy to University Park.

Yes

Other

If you selected "Other" above, please explain here.

Full Name *

Will help to distinguish you from another student with a similar name or names.

PSU Email *

Helps to verify that you are a Penn State student and to distinguish you from others.

Standing *

College *

Major *

Study Preferences (check all that apply)

Day(s) of the Week *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Any

Required

Time of Day *

Morning

Afternoon

Evening

Any

Required

Location *

You decide.

220 Boucke -- Penn State Learning (limited open hours)

7 Sparks -- Penn State Learning (limited open hours)

Libraries -- check for hours (http://www.libraries.psu.edu/psul/hours.html)

HUB -- open 24 hours

Residence Hall Commons

Any

Other

Required

"Other" location to meet

A well-traveled public location. You decide.

Angel Group

I give Penn State Learning permission to subscribe me to a Study Buddy ANGEL group so that I can contact others who are enrolled. *

Yes

Other

Elaborate on any previous response. Also, comments, suggestions, or any special considerations or concerns

Student Safety and Personal Information

Understanding the importance of student safety, this program encourages its participants to be cautious of the personal information provided in the questionnaire. The purpose of this program is to provide Penn State students more access to convenient academic resources; however, participants should always be vigilant when given or giving personal information. If the participant believes that s/he is being harassed or that her/his personal information is being used in an irresponsible or disrespectful manner, s/he should contact University Police (814-863-1111). Also, in utilizing this program students agree to use the information they receive in a lawful and responsible manner and strictly as an academic resource. When arranging meetings with a study buddy, students should select a well-traveled public location to meet (such as the library, HUB, dining commons, learning lab, or other area appropriate to the time selected).

University Risk Office, September 9, 2013

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