Academic Mentoring: Student Self-Alert Form

The Student Navigator provides early intervention services for students. If you are behind in classes, feeling overwhelmed, or need help getting back on track, complete this form for one-on-one assistance.

How can we help you?*

I want to ask a question. (I have a question about locating information or getting connected with the right person at the college.)

I want to submit a self-alert. (I have a personal hardship, academic concern or attendance issue that is affecting my classes.)

Name*

First Last

Student ID #*

Phone

Student Email Address*

Personal Email Address

Check all that apply.

I am currently enrolled in LTC classes

I am a high school student taking college classes

I am a GED student

I am a military affiliated student (I, my spouse, or my parent is serving in the military or has served in the military)

I am currently receiving disability-related accommodations in my classes.

None of the above

How did you hear about us?

Comments

This field is for validation purposes and should be left unchanged.

Academic Mentoring: Student Self-Alert Form

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