Early Alert System Referral

Please check all that apply. This referral form, when completed, will be sent electronically to Student Engagement and Success.

  • This is the the Student Identification Number

  • Referral for Academic Performance:

  • Select all that apply

  • Please provide us with any additional information you feel appropriate

  • Referral for Attendance Issues:

    FIRST WEEK of classes: Due to frequent schedule changes, please do not send EAs
    SECOND WEEK of classes: Please monitor attendance closely and begin sending EAs
    REMAINDER OF THE SEMESTER: please send EA only after you have attempted to contact the student first

  • / / Pick a date.
  • I have attempted numerous times to contact the student by:

  • *** Please use this form only when other options have been exhausted ***

Referral for Behavioral Concerns:

If this is an emergency, dial 911!

To have dispatch get an officer (24/7), please dial 589-5807.

To talk with ASU Police Department office personnel, please dial 587-7901.

For the following non-emergency behavioral concerns:

  • Students attitude and/or behavior is disruptive in the classroom
  • Comments of concern from other students
  • Change in demeanor and/or physical hygiene (i.e. anxiety, aggression, depression, appears tired constantly, has difficulty staying awake)

Contact Student Affairs directly at klmarque@adams.edu

Referral for Personal Issues Affecting Student:

For the following:

  • Health issues
  • Relationship issues

Contact Student Affairs directly at klmarque@adams.edu

For the following:

  • Financial issues

Contact Financial Aid directly at ascfa@adams.edu