University College Student Referral

Enter the professor's first and last name
Enter the professor's email including the @kysu.edu
Enter the student's first and last name
Enter the professor's email including the @
Enter the student's ID
Enter the class and section
Behaviors currently impeding academic progress*
Check all that apply
Enter displayed behavior in space provided
Faculty recommendations based upon reasons above*
Check all that apply
Enter displayed behavior in space provided