Retention Alert Report Form
Please use this form to alert your campus' Retention Team to any student who may be in need of assistance.
Fields with a
*
are required.
Instructor Name:
*
(please include your area code)
Telephone:
Date:
Student Name:
*
Course Section Number:
Problem:
I have done/tried the following:
Please select your campus:
*
Clinton Community College
Muscatine Community College
Scott Community College
