_________ Fall Semester _________Spring Semester 201__
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:
Course________________________ Grade____________________ Repeat? (D/F)_______
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