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Academics
MYACU
Wildcat Central
Retention and Student Success Notification Form
This form notifies the Retention and Student Success team that a student has indicated they may not return to ACU. As much as you are able, please provide as much detail pertaining to the student's situation. This form will allow staff to begin preemptive, wrap-around care for individual student success and retention.
A student will not know they have been flagged by you or the university, our goal is to deploy proactive support to help a student retain.
Student Information
First Name
Last Name
Email Address
ACU ID
Submitter Information
Submitter Name
Submitter Email
Relationship to Student
Reason for indication student is considering leaving campus
Reasons
Reasons
Lack of Finances
Academically unprepared
Fit/Culture
Family Crisis
Homesickness
Roommate Conflict
Mental Health
Better opportunity for career development
Please provide a detailed explanation
Any existing relationships or interventions already taken with the student?
Yes
No
Please provide a detailed explanation
Please list any other faculty/staff that has a relationship with this student that you are aware of .
Please list any known student engagement? i.e. student organizations, sorority or fraternity, etc.
What specific thing do you believe could keep this student at ACU?
Additional Comments
Submit
