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If you believe a student is in danger of dropping out, please take a few moments to fill out the following four items. You can choose as many options for #3 as you wish.

The Office of Student Success will collect this data and contact the student.
1. Faculty or Staff First Name
Faculty or Staff Last Name
2. Student's First Name
Student's Last Name
Student's Middle Initial (if available)
3. Academic factors causing concern (choose one or more):
Missing classes (3 or more day; 2 or more night)
Not turning in homework/classwork
Failing tests
Behaving inappropriately in class

Please contact if you have any questions regarding this survey.
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