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    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
    Submitter Information
    Reason for indication student is considering leaving campus
    Reasons
    Reasons
    Any existing relationships or interventions already taken with the student?