Academic Skills Center

Client Referral Form

This Referral Form serves as a request for a tutor OR verification that listed student is a Craven Community College student and therefore eligible to use the Computer Lab, Math Lab or Writing Lab. Tutoring is an additional service provided by CCC with qualified tutors.

Our Students need to have a Referral Form for EACH LAB or SERVICE they receive from the center. Thank you for your help!

If you have any questions, please call Opal Harris at (252) 638-7321 or Michelle Davis at (252) 444-0707.

The student is taking your class via:
First Name:
Last Name:
Semester
Student ID Number:
Specific Needs of your Student:
Curriculum Course: Class: Section:

The Student needs assistance in the following area:

NOTE: You can only select only one area per request.





Instructor's Name:
Instructor's Email:
By entering your name on the line above, you are verifying the listed student is being referred by you for tutoring and is a Craven Community College Curriculum student.


To avoid a false submission, type into the Text box: and then select the "Submit Form" Button.