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Academic Alert Form

The Academic Alert Program is designed to enhance student success at Western New Mexico University. In an effort to assist and retain students that are at risk of failing, dropping out of a course or withdrawing from the University we have established an Academic Alert program to reach these students and offer the supportive services necessary for them to be successful. This form will be sent directly to the Office of the First Year Experience and the student will be contacted to make an immediate appointment with his or her advisor.

Student's First Name:          Student's Last Name:       

Student ID Number:                           

Instructor's Name:            
Instructor's Email Address:

Course CRN:                             Course Title:     

Please check all areas that apply to the student:













Course Grade:

To date student has earned out of points possible.

Percentage of the course is complete:

Instructor Comments:
Please describe how you have interceded with this student:

Additional comments:

Advisor Follow-up Comments:



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