Brandeis University Report form for University Writing Seminar TO: Lisa Hardej (A-E) Katie McFaddin (F-K) PJ Dickson (L-Q) Laurie Nelson (R-V) Brian Koslowski (W-Z, Intl.) Office of Academic Services DATE: FROM:___________________ Dept.___________Ext._______E-mail__________ (instructor's name) COURSE: UWS ________SECTION________ REGARDING:_________________________ SID_______________________ (student's name) The best way of reaching me about this student is: The student named above is in danger of failing my course, for the following reason(s): _____3 or more unexcused absences _____missing/late work _____unsatisfactory My assessment of this student's work in my class thus far is as follows: Your intervention and your assessment of this student's performance would be helpful in trying to ensure his/her successful completion of this semester's work. Please contact me once you have met with this student. Thank you. cc:Student Dawn Skorczewski, Director of University Writing