Academic Alert and Intervention Program

This form will be submitted to the Academic Resource Center.

A staff member will review the submission and contact you, the student and any appropriate coaches or advisors. All check-marked information will be shared with the student. Additional confidential comments boxes are at the bottom of this form.  Please feel free to make comments about any area of concern in these boxes. The confidential information shared will assist staff in developing a clearer picture about the concerns you have to share without the student seeing these comments.

To ensure appropriate use of this form, users are required to login by entering their Marietta College user name and LDAP password.

  • The user name is the original College email handle that precedes the "" suffix.

    I.e., if the email address is, enter "arc"—not "" or an alias such as ""
  • The LDAP password is identical to an email or MyMarietta password.


Faculty, Student and Course Information

Faculty/Staff User name:  
Network Password (LDAP password):  


Student Name:
Course Name:
Course Number: (ex. Psyc 101) Section Number:  

Please identify the factors that warrant an early academic warning.
(Check all that apply.)


The student...

frequently misses class. has missed the maximum per attendance policy.
is frequently tardy. frequently leaves early.
has never attended, but is registered. frequently sleeps during class

Class Participation and Assignment Completion

The student...

does not complete assignments. submits assignments of consistently poor quality.
is not prepared for class. does not participate in discussions.
does not appear to be engaged in the class (doing other activities, using a laptop, etc). exhibits a low level or lack of participation in group work.
has not purchased the required texts for the course. frequently does not meet assignment deadlines
has difficulty with course content. If so, please explain.

The student...

has poor performance (low grades) on quizzes and exams. has not taken an exam and/or quiz.
(Ex. student rushes through exams, student frequently exceeds time allotted, etc.)
Personal or Social Factors

The student...

appears to be having difficulty adjusting to college. appears to be having difficulty balancing academic and non-academic activities.
appears to be having problems adapting socially.
appears to be having personal or emotional issues.  If so, please elaborate.
may have housing/roommate concerns. may have health concerns. may have financial aid concerns.



The student requires assistance with...

writing skills. test taking strategies.
study strategies. time management

Interaction with Student

I have ...

discussed the situation with the student.
provided written feedback to the student.
personally attempted to contact the student via email, cell phone campus mail, etc.

The student has...

not contacted me for assistance.
missed appointments with me.
not responded to my attempts to contact him/her.

If the present level of work is continued,
this student is in danger of receiving the following course grade:
C- D+ D D- F
I encourage the student to:
see me during office hours schedule an appointment in the ARC seek a tutor through the ARC attend study/help sessions
Additional Comments to be shared with student:
Additional Comments for staff/faculty use only: