You may Print this application page, complete all sections, and return it to the Writing Center in Kiely Hall 229 during our office hours. However, remember to first read Writing Center Information before completing this from. QUEENS COLLEGE WRITING CENTER APPLICATION
1. Name :________________________________________________________________
                          (Last/Family)                                                         (First/Given)

2. SS#:____________________________                 3. Email:__________________________

4. Address:______________________________________________________________
                  
                   ______________________________________________________________

5. Phone Numbers: (Home)_______________   (Work)______________ 

6. Current Status (circle one):  Freshman    Sophmore    Junior    Senior   Graduate

7. Current Writing Test Score:_____                                  [ Post Score:_____ ]

8. Native Language_______________                                9. Major_____________

10. What writing course are you taking this semester? CESL____English 95___ 110___ 
      
      English 120_____ Writing Intensive_________________________Other___________________

11. Did that instructor refer you here? Yes___   No___

12. Please list that course's instructor, department, and course number:

      _______________________________________________________________________________
                 (Instructor)                              (Dept.)                                        (course#)

List the days and times you can come to the Writing Center when it's open. Be very flexible. 
The more days and times you list, the better your chances of getting help.
      

 MONDAY

TUESDAY 

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

SUNDAY
             

I have read, understood, and agree to the procedures in the Writing Center Information section.

Signature:____________________________________________                     Date________________