ELAR Student Report

Instructor Name *

Instructor Email *

Student Name *

Student ID (A#) *

Course Number *

Course Section *

Items impacting academic success *

Attendance

Missed Assignments

Weak Writing Skills

Weak Reading Skills

Apathy

Poor Student Skills

Other (Please specify below)

Notes

if "Other" was selected, indicate reason here or any other comments you wish to provide

Suggested Action

Final Class Grade

If you happen to see this, do not fill this field.