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DGroup Student Information Form

To register as a DGroup Leader, please complete and submit the form below.

Please fill all out fields.
Personal Information
Student ID:
 First Name:
 Last Name:
Home Phone:
 Cell Phone:
Practicum Class:
 Professor:
Indicate which role you would prefer:
Would you be willing to teach past material to students making up requirement? (yes or no)

Available Options: (PLEASE READ CAREFULLY)
You may meet anytime (one hour slot) on Monday, Tuesday or Thursday between the hours of 7:30AM - 9:30PM, and Wednesday or Friday between the hours of 7:30AM - 5:00PM. Please note that you may not meet on Tuesday, Wednesday or Thursday during Chapel, 10:00-11:00AM.

In the boxes below please indicate the day and time (am/pm) that you would prefer to meet. If at all possible your first choice will be priority, however we may use your second or third.
Indicate Day and Time (e.g. M 8-9AM)
Choice One:
 Choice Two:
 Choice Three:

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