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HOME
form
nursing lec referral
LEC Referral
LEC Referral
Student's Full Name
Referring Instructor's Full Name
What is your e-mail?
Reason(s) for referring this student
Scored 76 or below on Test
Midterm average <76
General difficulty with course
Poor study habits
Poor time management skills
Other
Other
Which nursing course(s) is the student experiencing difficulty?
NUR 3010
NUR 3030
NUR 3040
NUR 3050
NUR 3100
NUR 3150
NUR 3200
NUR 3450
NUR 3500
NUR 4000
NUR 4120
NUR 4150
NUR 4350
NUR 4450
NUR 4510
Please describe what problems the student is experiencing:
What is your suggested course of action for this student?
Leave this field blank
