Early Warning Form


Please fill out this form and select submit at the bottom of the page. The Center for Student Achievement will use the information to contact the student and encourage him/her to seek out available resources (whether it be tutoring or meeting with you, the instructor). You will receive a copy of any correspondence sent to the student.

Information you provide on this form may be shared with the student, who has legal access to this information. Observations should be objectively stated.

While this form is intended to reach students prior to the withdrawal date each semester, you may submit a form at any time. If you have any questions regarding the Early Warning System, please contact the Center for Student Achievement at 803-641-3297 or csa@usca.edu.

* Instructor (full name):
* Instructor's Email:
* Course:
* Student Name:
* Date:
* Section:
Please check any statements, that in your judgment, describe this student.
Student is missing classes
Please select number of classes missed:
Student is habitually late
Student is continually unprepared:
Student lacks essential skills
Select area where student needs improvement:
Student is not completing reading and/or assignments
Student struggles to keep pace with the class
Student does not take notes in class
Student does not participate in class
Student is not performing well on tests/quizzes
Student exhibits poor attitude and /or disruptive behavior
Other: