Focus on Retention: Completing the class!
Spring 2013
Name: ____________________________________________________
Course: ___________________Instructor:_______________________
Answer the following questions.
1.
Number of classes you are taking this semester: __________________
2.
Number of hours per week that you are working this semester: ________
3.
List of major personal responsibilities (children, spouse, committed relationship, caring for elderly parent, etc.):
________________________________________________________________
_________________________________________________________________
__________________________________________________________________
4.
List of weekly recreational activities: (going out, sports, hobbies, TV, Internet, etc.)
_________________________________________________________________
_________________________________________________________________
__________________________________________________________________
5.
Rate your time management skills on a scale of 0-100: __________________
6. Are you aware of tutoring services? ________ Have you ever worked with a
tutor? ________
7.
Are there other factors that affect your attendance requirement (visa status,
financial aid, insurance, etc. )? ________
8.
Other factors that may affect your class attendance/completion of this course
________________________________________________________________
________________________________________________________________
________________________________________________________________
Based on your answers to questions 1-8, list any actions you may need to take to successfully complete this course. (Use back if necessary)