Go to Success Centers Home Page.

 


Study Group Request Form

Name of Primary Contact: CCRI Student ID #:
Home Phone #: Work Phone #:
E-mail address:

Course you're requesting to set up a study group for:
Instructor:

  M T W Th F S
9am-10am
10am-11am
11am-12pm
12pm-1pm
1pm-2pm
2pm-3pm  
3pm-4pm  
4pm-5pm    
5pm-6pm    
6pm-7pm    
7pm-8pm    


Please choose your campus:

I was referred to the Success Center by:

Self            Friend         Instructor         Other


Do you have other students ready to join your group?
Yes   No

If so, list names: