Brandeis University Report form for University Writing Seminar

TO: Lisa Hardej (A-E)

Katie McFaddin (F-K)

PJ Dickson (L-Q)

Laurie Nelson (R-V)

Brian Koslowski (W-Z, Intl.)

Office of Academic Services

DATE:

FROM:___________________Dept.___________Ext._______E-mail__________

(instructor's name)

COURSE: UWS ________SECTION________

REGARDING:_________________________ SID_______________________

(student's name)

The best way of reaching me about this student is:

The student named above is in danger of failing my course, for the following reason(s):

_____3 or more unexcused absences

_____missing/late work

_____unsatisfactory

My assessment of this student's work in my class thus far is as follows:

Your intervention and your assessment of this student's performance would be helpful in trying to ensure his/her successful completion of this semester's work. Please contact me once you have met with this student. Thank you.

cc:Student

Dawn Skorczewski, Director of University Writing