Course Instructor Concern of Attendance

Dear Faculty Member, Course attendance and student success go hand in hand. As a way to improve student performance, the online submission form below is to alert the SCA Academic Advising Office of a student with excessive absences. Please complete after you have privately contacted the student in jeopardy and have not received a reply within 48-72 hours. The information provided will be shared with the student's faculty advisor and the Dean's Office. Thank You, scaadvising@sage.edu*
Date (MM-DD-YYYY)
Term
Year (YYYY)

Instructor Last Name
Instructor First Name
Instructor's User ID ("____"@sage.edu)

Course Department
Course Number
Course Section

Student Last Name
Student First Name

Concern *Please use space below for other concerns.
Student Date of Last Attendance	Not Applicable
Instructor has contacted student regarding concern(s)?	Yes No
Student date of last contact with you
Withdraw from course recommended*	Yes No Other (please provide comments below)
Comments: Please use the space below to provide additional information or other concerns. (250 characters maximum)


*The undergraduate course withdrawal deadline is posted on the Academic Calendar.