Office Use Only: Academic affairs confirms the following: ___ Started semester in good academic standing Education Guarantee ___ Enrolled in 12+ hours/no more than 50% online Student Responsibility: ___ Earned < 2.0 GPA in semester of EG 1. Start the semester (fall or spring, does not apply to summer terms) in good academic standing with the University. ___ All classes for semester are listed below Missouri State University-West Plains 2. 3. 4. 5. 6. 7. Enroll in 12 or more credit hours (no more than 50% of the credit hours can be online). Attend class and have no more than 2 absences in each class during the semester. Turn in all assignments by the deadline specified by the instructor and take each examination and test. Visit each instructor at least once outside of class during the instructor’s regular office hours. Meet with academic advisor at least once during the semester during the advisor’s office hours. Use the free tutoring services at least three times during the semester for each class. Education Guarantee granted for the following courses in which the student earned ‘D’ or ‘F’: Course 1 Course 2 Course 3 Course 4 Missouri State University-West Plains Guarantee: If a student who has fulfilled the responsibilities outlined above and earns a term GPA less than 2.0, Missouri State UniversityWest Plains guarantees that they will be allowed (one time only) to retake every class that the student earned a grade of ‘D’ or ‘F’ in, tuition free (all fees, however, still apply, e.g., computer usage, professional services, etc.) the next time the class is offered in a regular semester. Students must apply within three weeks following the last day of final examinations for the semester to be eligible for this guarantee. Student Name (print): M#: Semester: Fall Spring Application for Education Guarantee. As part of the application process and to verify that the student meets the Student Responsibility section of the guarantee, the student should fill out verification sections 1, 2, and 3. Students can contact instructors, advisors, and specialists on campus, by phone or email. Instructors, advisors, and specialists can verify this information by signing this form or contacting academic affairs by phone (417) 255-7272 or email TeresaShipley@MissouriState.edu). 1. Instructor Verification. List all classes from the semester that made the student eligible for the EG. The instructor from each class should verify that the student had no more than 2 absences during the semester; turned in all assignments by the deadline specified by the instructor; and visited with instructor outside of class at least once during office hours. Course Title Instructor Instructor Signature 2. Advisor Verification. The advisor should verify that the student met with the advisor at least once during the semester during office hours. Advisor Signature: Date: 3. Tutoring Verification. Verify that the student used the tutoring services the required number of times during the semester. Writing/Mathematics Specialist Signature: Date: 4. Student Signature: Date: Guarantee Approved: Dean’s Signature: Copies To: student, business office, financial aid, registration/records, advisor Date: AA – WP revised 2015/6/2