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Early Warning Intervention (EWI) Form

Confidential Information

 

Instructions to Professors

Please submit EWI reports for students who are not making satisfactory progress in your classes. EWI reports may be submitted at intervals of 4 weeks and 7 weeks during the 14-week semester, or whenever you feel students need help. Please fill in all blanks which apply and submit the information using the Submit Button at the bottom of the page (the information will be sent via e-mail to the Center for Academic Support and Diversity).  Please call 424-3082 if you have any questions.


Professor Information
Name:
Email:
Department:
Phone #:
Semester:

 

Student Information
Name:
Titan ID:
Subject:
Course:
Class#: Section:


Is intervention needed?

Yes No

Grade earned to date:

A A- B+ B B-

C+ C C- D+ D D- F

Pass Incomplete

Attends class?

Yes No Pit-Class

 

Please check all areas in which you feel the student may need help:

 

Attendance Homework Note-taking
Class Participation Lab Quiz
Counseling Paper(s) Textbook Reading
Exam(s) Project(s) Tutoring
Other


Professor/Counselor Comments:


(Click Submit to send information)

 

 

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Department Info

Interim Director: Irma Burgos
Office: Center for Academic Support & Diversity
Phone: (920) 424-3081

Fax: (920) 424-3083