BC Freshman Institute Learning Lab/Tutoring Referral Form
BC Transformers: Enter with Pride; Exit with Power
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Person Making Referral
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Date of Request
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Student Last Name
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Student First Name
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Student ID#
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Semester/Year
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Spring 2012
Fall 2012
Spring 2013
Fall 2013
Spring 2014
Fall 2014
Spring 2015
Fall 2015
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Course Name
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Course Prefix
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Course Number
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Course Section
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Instructor Last Name
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Reason for Referral
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Math Lab
Reading Lab
Writing Lab
Tutoring Assitance Needed
Other:
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Specific Tutoring Requirements
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Two Days per Week
Three Days per Week
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Type of Instructional Assistance
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Please indicate the topic(s) for which you recommend instructional assistance for this student for the current semester.
Whole Numbers
Fractions
Decimals
Percents
Ratio/Proportions
Geometry
Measurement
Order of Operations
Exponents/Roots
Simplifying/Evaluating Expressions
Solving Linear Equation/Inequalities
Graphing
Formulas
Polynomials
Factoring
Rational Expressions
Rational Exponents
Systems of Equations
Functions
Exponential/Logarithmic Functions
Rational, Radical, Quadratic Equations
Complex Numbers
Transformations
Sets/Logic
Basic Statistics
Probability
Add/Sub/Mult/Div Integers
Combining Like Terms
Grammar/Punctuation
Reading/Vocabulary
Paragraphs/Essay Structure
Idea Generation/Pre-Writing
Oral Presentations/Speeches
Research Paper
Other:
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