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Early/Ongoing Academic Intervention System
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Early/Ongoing Academic Intervention System
Instructor Name
(Required)
Instructor E-Mail Address
(Required)
Course & Section Number
(Required)
Student First Name
(Required)
Student Last Name
(Required)
Student ID Number
(Required)
Student E-mail
Student Phone Number
Factors
(Required)
The above student is experiencing academic difficulty and is in need of assistance. Contributing factors include:
High rate of absenteeism
Habitual tardiness
Failure to turn in assignments
Submission of poor quality assignments/papers/projects
Missed tests, quizzes, or major examinations
Low test/quiz performance
Class disruption, disrespect, etc.
Other difficulties (Explain):
Instructor Comments
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