Name*

I am a EIT Student EIT Distance Student Other

ID Number*

Email*

Cell Phone*

Programme

Support Type
(Please tick) Assignment Writing     Writing Skills

APA Referencing     Study Skills

  Strategies for Studying Anatomy and Physiology

  Mathematics     Drug Calculations

Basic Computing Please specify:

Other Please specify:

Date* Time*

Date Time  

Date Time  

Date Time  

Date Time  

 

Note: Filling out this form does not guarantee you will get an appointment. You will be contacted only if an appointment becomes available.

 

*indicates a required field