Early Academic Referral System (EARS)

EARS is a program designed to help students improve academic performance, succeed and persist toward their goals and credentials. Any student in a SuccessNow Learning Community who is identified as potentially in danger of not making satisfactory progress for which the instructor and student have not found a satisfactory solution will be referred to that Learning Community’s Educational Case Manager, and when and where relevant to an appropriate support service. Once identified, an Educational Case Manager will work with him or her in conjunction with the College's academic advising system and other support services in an effort to improve classroom performance. Whenever possible, please speak to the student before completing this form. When the form is completed, please give to the Learning Community’s Education Case Manager. If possible, discuss with the Educational Case Manager.

Educational Case Manager: ________________________

Professor: _____________________________________

Student (last, first, EMPLID #): _______________________, _______________, #_____________

Course, Section, Course PS#: ______________, _____________, #_____________

Attendance/Participation

___ Absent more than one day during the first two weeks of class.

___ Consistently late for class.

___ Does not participate in class.

___ Leaves class early.

___ Sleeps in class.

Academic reasons for referral

___ Under-prepared for class.

___ Lack of preparation/withdrawal from classroom activities.

___ Lack of preparation/withdrawal from classroom activities.

___ Decline in quality of assignments/test performance.

___ Difficulty with assignments.

___ Difficulty with note taking, test taking and study skills

___ Difficulty with writing assignments

___ Difficulty with math assignments

___ Difficulty with science assignments

___ Student may have a disability (please make notation in comments section).

Non-academic reasons for referral

___ Illness

___ Overt statements regarding difficulties.

___ Overt changes is demeanor (i.e. anxiety, aggression, depression, etc.)

___ Work conflicts

___ Family Conflicts

Faculty/student interaction

___ Yes, I have spoken to the student about this referral.

___ No, I have not spoken to the student about this referral.

Instructor’s recommendation

___ Student should withdraw from class.

___ Student Should remain in class and seek academic interventions

Suggestions for Improvement (referral for additional assistance, tutoring, study skills, test-taking skills, counseling, etc.):

Additional Comment – if requesting tutoring, be specific on problem areas & what the student & tutor should work on: