Instructors in any class, at any time, may submit an Academic Warning or Referral for students who are not performing up to expectations. The instructor may recommend specific steps to be taken, as part of this submission. A copy of the warning/referral is kept in the student's Advising Services file, and the original is mailed directly to the student. Students who receive warnings are always urged to meet with their Academic Advisor to assist in successfully completing the course. 

Instructions: 

This form can be used in multiple capacities:

1) as an "Official Academic Warning" to let students know that their progress in the course is unsatisfactory
2) as a "Referral" indicating that you would like the student to meet with the LRC
3) as a "Referral" for the student to meet with an Academic Advisor, which can be specifically related to a class or when submitted by a non-instructor can be related to non-class specific topics

The completed form will be reviewed by an Academic Advisor, and then sent to the student. The comments on the form are very helpful for the Academic Advisors to have productive conversations with the students, but they are also given directly to the students. Please do not use this form as a substitute for having your own conversations with students about academic performance. Please refer to the Faculty Handbook if you have questions. 

This form should be used as soon as a student is underachieving, at week 4 of an 8 week class or by week 8 of a 16 week course as a mid-semester warning, or prior to the withdrawal deadline for any student who may be in danger of failing your class.

Please fill out both sections, below.