MCC EDUCATIONAL ASSISTANCE PROGRAM
APPLICATION FOR RECEIVING SPECIAL SERVICES

Hand deliver this signed application to Lisa Gardner in Doser 318 or fax to 989-328-2950.

NAME _____________________________________________________________

Student ID # ____________________________ Semester ____________________

e-mail address ____________________________

Phone # _____________________

Is your Degree/program an Associate, Certificate, Neither (Circle one)

LIST THE COURSE(S) YOU DESIRE ASSISTANCE IN

Course ___________________ Instructor _________________________________

Course ___________________ Instructor ________________________________

Course ___________________ Instructor _________________________________

Are you receiving FINANCIAL AID? Yes or No (Circle one)

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PLEASE READ AND COMPLETE REVERSE SIDE.
STUDENT RESPONSIBILITIES FOR RECEIVING SUPPORT SERVICES

The Educational Assistance Program at Montcalm Community College provides academic assistance in the form of tutoring and other support services. These services are free and available in course(s) which assistance is necessary.

To best assist, you, the student in obtaining the maximum benefits from your services, we request that you review and agree to the following guidelines:

A. Student Obligation:

1. I will come to tutoring sessions on time and prepared with lecture notes, assignments, textbooks, etc.

2. I will communicate and coordinate when assignments are due, and develop time lines to complete objectives.

3. I will come to tutoring with all homework completed and use the tutoring time to review those areas in which I am having difficulty.

4. I will contact the tutor when I will be absent as far in advance as possible.

5. I will wait 30 minutes in case of late arrival of my tutor.

6. I understand that receiving tutorial services is contigent of class attendance.

7. I authorize release of documents, transcripts, and ASSET/COMPASS assessment results to be used to verify the need of assistance. Information may be shared with the following people/agencies:

______ Faculty, according to your scheduled courses

_____ College Personnel, including Registrar, Financial Aid Director, Dean of Student Services

_____ Family Members (Names: __________________________________________________)

_____ Previous/Future Education Institutions

_____ Other (State names or agencies: _____________________________________________)

8. I understand and agree that I am giving authorization for the academic counselor to share this information with the above people.

9. I understand that I must have documentation of my disability on file with the academic counselor to be eligible for services and accomodation recommendations.

B. Cancellation Procedure:

1. It is important to give 24 hours notice for an absence whenever possible. Call your tutor and follow up when appropriate.

2. If a student misses and fails to cancel two sessions, the service will be discontinued.

3. If a student has a pattern of erractic class and/or tutorial attendance, the service will be discontinued.

4. Students must meet with an academic counselor to discuss renewal of services.

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Signature/Date