English Language Training Program

700 University Blvd Cousins Hall Rm. # 217

MSC 147 Kingsville, Texas 78363-8202
Voice: (361) 593-2855 Fax (361) 593-4964
www.tamuk.edu/eltc

Registration Form (Current TAMUK Students)

For Non-Native English Speakers Tutorials
Printed Name:

Date: ______

K#:

Email: __________________________

Phone:

Are You a Repeat Client? (

Native Language:

Major:

) Yes / (

) No

Subject or area for tutoring:

Check one item below:
One-on-one Tutoring (30-minute): $10.00
One-on-one Tutoring (1 hour): $20.00
One-on-one Tutoring (3 hours): $50.00
Group Tutoring (1 hour): $30.00 (1-4 students who are self-paid)
Group Tutoring (1 hour): $30.00 (2-5 JESSC paid students free for engineering students)
Payment:

* Need receipt of payment before 1st session

) Marketplace* https://moneyconnect.tamuk.edu

) Business Office*
College Hall 955 University Blvd. Kingsville TX, 78365
Please request an invoice to pay at the Business Office

) JESSC Sponsorship (for engineering students only)

Schedule:
Please write down your preferred days and times (at least one in the morning and another one in the
afternoon) for your tutoring session to take place. Actually Days and times depend upon our tutors'
availability. You will be contacted by the ELTC office within 2-3 days after your registration to
confirm your tutoring session (date and time).
Days

Morning (A.M.)

Afternoon (P.M.)

Monday
Tuesday
Wednesday
Thursday
Friday

Please come to the ELTC office to schedule your session. Days and times offered vary depending
on your schedule and the tutors availability.
When registered for a tutoring time, you must be on time for your appointment or you will have to
reschedule for another date and time with the tutor/ELTC office.
There are no refunds on session if you are late to the session or missed the session time completely.

Participants name (please print clearly)

Participants signature

Date

FOR OFFICE USE ONLY

Number of hours purchased
TIME

Monday
Tuesday
Wednesday
Thursday
Friday