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Hello Students! Can’t find your textbook online? Email Kathy Wenthold [wentholdk@uiu.edu] with the course name/#. Unable to access your bookstore voucher? Email Andrew Ransom [ransoma@uiu.edu]. Both are happy to assist!

You are here:  Support Our Students (SOS)  

Support Our Students (SOS)

 

 

 

 

Date:

9/19/2017
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Student Name:

 

Student ID (if known):

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Course/Location of Observed Behavior:

Reason for Alert (Select all that apply)

 

Academic:



 

If Excessive Absences, please select last day of attendance:

 

Please provide details on boxes selected in this section:

 

Non-Academic








 

Please provide details on boxes selected in this section:

 

Personal:






 

Please provide details on boxes selected in this section:

 

Other or Additional Comments:

 

Please provide details on boxes selected in this section:

 

What are your recommendations for support?(Select all that apply):







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What strategies do you recommend the student implement to improve the situation?

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Do you know of any reasons (observed or communicated) for the issue(s)?

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Please list the actions you have taken to help support the student:

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Referred by:

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Do you wish for your identity to remain confidential?


**Please note that we are unable to guarantee confidentiality in some situations