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Student Availability Form

Center for Distance Learning Home > CDL Current Students

PLEASE COMPLETE AND SEND THIS FORM DIRECTLY TO YOUR INSTRUCTOR FOR EACH COURSE IN WHICH YOU ARE ENROLLED.

Course No.________________ Course Name____________________________________

Term______________ Credits______________

Student's Name___________________________ I.D. (SS #)___________________

Address___________________________________________________________________

Telephone (Home)____________________________ (Work)________________________

Empire State College E-mail User Name______________________________ (FAX)___________________

Your tutor must have accurate information on the days and times you can be reached and know of any possible problems at the beginning of the term so that you can progress in your course work on schedule. Please contact your tutor during the office hours listed in the tutor introduction letter. List below other times you would be available for contact.

Day	(Area Code) Telephone	Time of Day or Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Describe any unusual circumstances your tutor may encounter telephoning you (e.g., you have no telephone at home; do not wish to be called at work; work unusual hours):______
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Do you have special needs of which your tutor should be aware?___________________
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Do you need a letter grade equivalent for graduate school or reimbursement purposes for this course?
___ Yes ___ No
If so, please remind your tutor of this during the term and when you complete the course.

Tutors often like to know something about their students. If you wish, please write briefly about your interests and goals. You may also include a photo of yourself, if you would like. _____________________________________________________________________
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If you are a Center for Distance Learning matriculated student and would like an identification card to facilitate use of libraries and other resources, we will prepare one for you. Instructions for obtaining a card are available.