Conversation Partner Request Form
Please fill out form completely
Name
Name
*
First
Last
Banner I.D.
*
Maximum of
9
digits allowed.
Currently Entered:
3
digits.
Brockport Email (requests without a valid Brockport email address will not be fulfilled)
*
Phone (optional)
Phone (optional)
-
###
-
###
####
What year are you in?
*
What year are you in?
-- No more choices left --
What is your academic major?
*
What languages do you speak?
*
Tell us about yourself (academic interests, hobbies, culture, etc.)
What are your goals? Check all that apply.
*
What are your goals? Check all that apply.
Sharpen English proficiency to improve learning in English
Become more comfortable participating in class discussion
Become a more effective presenter
Improve informal conversation skills
Improve pronunciation and fluency
Engage in cultural exchange
Other
Other
When are you available to meet with a Conversation Partner?
ASC Tutoring Hours
Mondays-Wednesdays 8am-8pm, Thursdays-Fridays 8am-5pm
Please list provide the days and times that you are available.
Please put an 'X' for any days for which you are not available.
Monday
*
Tuesday
*
Wednesday
*
Thursday
*
Friday
*
How often would you like to meet with a Conversation Partner?
*
How often would you like to meet with a Conversation Partner?
Just once for now
Once a week
Thank you for your interest in the Conversation Partner Program. An ASC Tutoring staff member will reach out to you soon.
Submit
