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Early Intervention Request Form

Distance Learning's Early Intervention Program focuses on DL students who may need additional support in a non-traditional learning environment, and assists faculty in keeping those students in their DL courses as active participants. By reaching out to at-risk students as early in the semester as possible, we can increase their opportunities for success in distance education courses at ACC.

Faculty should complete this form to request assistance in reaching students who have missed orientations, fallen behind in coursework, neglected to submit assignments or exams, or if DL can provide ACC student services referral information to you or your students.

Instructor Information:





Intervention Request:




(Please provide each at-risk student's name & 7-digit ACC Student ID Number.)

(Please explain how DL can assist you with your at-risk student(s). Provide the text to be distributed and/or background of the request so DL can provide the most appropriate referral for your students.)
Method of contact requested:
         

or

Note: After submitting the form, you will be redirected to the Distance Learning homepage.

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Austin Community College Distance Learning