Chitani LLC

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Chitani LLC, Mentorship and Tutoring Referral form

Student Information*

Available Days*

Academics*

Areas in need of support:

(check all that apply)

Time management

Attendance

Study Skills

Organization

Skill(s) deficiency

Homework

Poor Grades (include area of study)

Change in work quality

Cheating/Dishonesty

Other

Is this student in need of tutoring services?

Professional Development*

Areas in need of support:

(check all that apply)

Leadership

Communication

Goal Setting

Giving/Receiving Feedback

Conflict Resolution

Adaptability

Collaboration

Productivity

Emotional Intelligence

Problem Solving

Integrity

Interpersonal Communication

Teamwork

Decision making

Presentation skills

Flexibility

Professional appearance (grooming, attire, etc.)

Other

Career Pathway Support*

If applicable, choose area(s) needing further development:

(check all that apply)

Clinical Development*

Clinical Career Ladder

Exploring specialties (What’s your niche?)

Certifications

Committees

Professional Development Support*

Resume and/or Cover Letter Development

Educational and Employment Application Support

Interviewing support

Building a Professional Brand

I agree to share my email and mobile numbers with the chitanillc to enroll me in their education management system and i have no objections in it.

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New York, US

chitanillc@gmail.com

+1 5853098309

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