To be filed with the Registrar for every student who incurs an F grade at the end of the semester.
Student Course
Adviser
In the space below please give your opinion as to the reasons for the student's failure. The Board of Review, as well as the student's adviser, is particularly interested in reasons not limited to grades and numerical scores.
Reasons for failure
Number of absences
The above remarks may be divulged to the student unless confidentiality is requested by the instructor. Are these remarks to be considered confidential? Yes No
Date Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009 2010 2011
Signature