Special Support Services

Student Success Center
Learning Assistance Center
Special Support Services
Supplemental Instruction Program

Request for Services

NOTE: If you have never applied to SSS before, you MUST fill out and complete the New Student Application on the Apply for Services page.

* Indicates a required field

Page updated: July 8, 2009

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Special Support Services
The Student Success Center
The University of North Carolina at Greensboro
Location: 110 McIver Building
Street Address: 1008 Administration Drive, Greensboro, NC 27412
Mailing Address: PO Box 26170, Greensboro, NC 27402-6170
VOICE: 336.334.7533
FAX: 336.334.7990
EMAIL: sss@uncg.edu

Academic Year 2009-10 (select a semester)	Summer 2009 (Tutoring will not be offered during Summer 2009) Fall 2009 Spring 2010
Have you filled out a SSS Application or an Application for Continuing Services for the 2009-10 academic year?	Yes No (If no, an application must be completed before services can be provided.)
First Name:
Last Name:
Student ID:
Local/Campus Mailing Address:
Email: (userid@uncg.edu)
Phone Number:
Alternate Phone Number:
Check Services Desired: (select all that apply)
Tutoring Course(s) Requested: Please indicate Course name (ex: Biology), Course number (ex: BIO-111), and Course section (ex: 01) Limit tutoring requests to two (2) courses only.
Course 1:
Course 2:
Academic Skills: (select all that apply)
Concentration / Memory
Essay / Grammar
Graduate / Professional School Test Prep:
Learning Styles:
Listening:
Note Taking:
Procrastination/ Time Management
Reading Comprehension
Research Writing:
Study Skills:
Test Taking:
Other:
Counseling: (select all that apply)
Career Guidance
Financial Aid Assistance
Academic Counseling
Personal Concerns
Graduate School Guidance
Other Counseling Needs:

Learning Lab: (select all that apply)
Computer Literacy
Computer Research
Other Computer Use (i.e.: homework, email)
Tutoring Accountability Statement: By submitting this form, I indicate that the tutoring program policies have been explained to me fully, and I understand those policies and my responsibilities as a student. I understand that I may contact the Assistant Director for Tutoring Services if I have questions pertaining to tutoring policies and procedures.