Retention Services
Early Monitoring Form
Term: Fall 2013
Student Name:   
Course:
Instructor Name:
Attendance:
(please select one)
 Red - regularly late or absent
 Yellow - Occassionally late
 Green - On time
Academic Performance:
(please select one)
 Red - student shows early signs of academic problems
 Yellow - student shows moderate signs of academic concern
 Green - student is making appropriate progress and performing well
Feedback: High Risk:
  Medium Risk:
Positive Feedback: