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:
Instructor's Name:	ACC Email Address:
Campus:	Phone #:
Intervention Request:
Course:	Synonym:
Student(s) to be contacted: (Please provide each at-risk student's name & 7-digit ACC Student ID Number.)
Intervention Request: (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: Phone Call     US Mail     Services Referral
or

Distance Learning will notify you by email when the intervention action has been taken. Thanks for using DL's Early Intervention Program. When your students succeed, so do we!

 

Distance Learning Office
7748 HWY 290 West, Austin, Texas 78736
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Webmaster | Updated: November 28, 2007
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