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Heidelberg College Early Alert Form

Student Name:
Student ID (if available):
   
Attends Regularly Yes
No
Unable to answer
Has Satisfactory performance in class Yes
No
Unable to answer
Have you spoken to this student about your concerns? Yes
No
Unable to answer
 
This is for our information only, or would you like someone to contact this student?   Information Only
  Student should be contacted
   
Do you have any additional comments or recommendations that may be helpful in assisting this student?
 
Submitted by:
 
Phone Number:
 
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