_________ Fall Semester _________Spring Semester 201__
Name_______________________________ Banner ID @ __ __ __ __ __ __ __ __
Permanent Address____________________________________________________
Permanent Telephone ______________________
Local Address________________________________________________________
Local Telephone____________________ E-mail____________________________
Cumulative Grade Point Average (CGPA)______________GPA Hours__________
Advisor_____________________________________________________________
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Action Plan for Good Standing
List all courses for which your current grade is F:
List all courses for which your current grade is D:
The primary reason(s) for your academic difficulties have been:
Describe specific strategies you intend to adopt to address your academic difficulties and regain academic good standing:
List all courses you are taking or plan to take during your probationary semester. Indicate the grades you expect to earn and if the course is a D or F repeat
Course________________________ Grade____________________ Repeat? (D/F)_______
Course________________________ Grade____________________ Repeat? (D/F)_______
Course________________________ Grade____________________ Repeat? (D/F)_______
Course________________________ Grade____________________ Repeat? (D/F)_______
Course________________________ Grade____________________ Repeat? (D/F)_______
Course________________________ Grade____________________ Repeat? (D/F)_______
Course________________________ Grade____________________ Repeat? (D/F)_______
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I realize that if I do not make sufficient progress toward academic good standing, I will be dismissed at the end of this semester.
________________________________________ _____________________
Student Signature Date
