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Early Intervention Form

Early Intervention Form Menu

Please fill out one form for each student not making adequate progress in your course. This information will allow us to quickly connect the student with appropriate counseling and/or academic support. Thank you very much for your assistance.

General Student Information

Student’s problems in the course arise from (Check all that apply):
Poor Attendance
Academic Performance
Inadequate Preparation
Overall Performance To Date
Recommended Intervention
Submitter Information