Columbia State Home Student Success Home

Student Success Home

Students

Faculty

 

 

 
 
 
 
 
 
 
 
 
 
 
Address
1665 Hampshire Pike
Columbia, TN 38401
Phone
931.540.2572
931.540.2793 (fax)
1.800.848.0298 (TDD)
E-mail us
Early Alert Form
The early alert form is designed to provide a quick and easy referral system for faculty
and staff to refer a student having difficulty early in the semester. The Student Success Counseling Office will then contact the student to offer personalized assistance and referrals.
Ideally, you will want to communicate with the student and let them know you are concerned with their progress and want to connect them with additional resources outside the classroom.
While this form is intended to be an early alert form, you may submit this form at any time during the year.
 
Faculty/Staff Name:
E-mail
Student Name:
Student SSN/SID:
Course Name/Section:
   
Please check any statements that describe the student.
 
Student is missing classes: Number of absences:
Student is habitually late: Student is unprepared:
Student does not take notes: Student lacks basic skills:
Student does not complete assignments: Student does not participate in class:
Student is not performing well on quizzes/exams: Student has poor attitude:
Student may be having personal problems:    
       
Other:    
       
       

 
 
   

 

  
     

Return to Top

Students

Faculty