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Refer a Student
This form allows student to refer himself and/or academic advisor/course instructor to refer students who need extra care and assistance, to counselling and advising center, or to prep year/ Freshman advising & caring unit or Student Success Center. Referred students will be contacted to arrange for appropriate support and follow-up.

Person Making Referral

Student Information

Referral Information

  Relation with Student
Self
Academic Advisor
Course Instructor
Admission Office
Prep Year student Advising & Caring Unit
Freshmen Student Advising & Caring Unit
  Refer To
Center for Advising & counselling
Prep Year student Advising & Caring Unit
Freshmen Student Advising & Caring Unit
Learning Support Unit @Student Success Center
  Does the Student know you have referred him?
Yes    No
  Difficulties this student might be experiencing?
Academic
Non Academic
  Issues Reported or Observed:
Not Attending Class - الغياب عن المحاضرات
Not Performing Well - ضعف الأداء
Personal issue (Family, Financial etc.) - قضايا شخصية
Behavioral issue (Describe below) - مشاكل سلوكية (حدد نوع المشكلة)
Other (Describe below) - أخري (حدد نوع المشكلة)