ATP Tutor Certification Application
All certification applications should be typed. Please do not submit handwritten forms.
Name to be printed on certificate:
_______________________________________________________________
Mailing Address: ____________________________________________________
City: ________________________ State: ________ Zip Code:________
Phone Number: ____________________ Fax Number: _____________________
E-mail Address: _____________________________________________________
Name of Institution/Tutor Program: ________________________________________
___________________________________________________________________
Below please circle the desired tutor certification level and whether this application is for a new ATP tutor certification or a renewal of an existing tutor certificate.
|
Tutor Certification Levels |
New Certification |
Renewal |
|
Associate Tutor |
$10.00 |
$5.00 |
|
Advanced Tutor |
$20.00 |
$10.00 |
|
Master Tutor |
$30.00 |
$15.00 |
Associate, Advanced and Master Tutor certification & renewal packets (with 1 original & 3 copies of all materials) should be mailed to:
Ms. Beth Nikopoulos Assistant Director Student Life North Lake College
5001 N. MacArthur Blvd.
Irving, Texas 75038
