TechnicalCollegeoftheLowcountry
StudentofConcernForm
ThisformgoestoTCL’sDeanofStudents’Officeduringnormalbusinesshours.Itisnotmonitoredafter
hoursonweekends,oroncollegedays.Shouldyouhaveimmediateconcernscallcampussafetyat
BeaufortCampus:525‐8301or986‐6971
(cell);NewRiverCampus:470‐6004or812‐4115(cell).Incase
ofanemergencycall911immediately.Ifyouprefertodiscussyourconcernorifthenatureofyour
concernisofasensitivenature,pleasecall525‐8219.
ContactInformation
YourName:
YourPosition:
YourEmail:
YourPhoneNumber:
Wouldyoulikeustocontactyoupriortocontactingthestudent? Yes No
StudentInformation
NameofStudent:
StudentIDnumber:
StudentPhone:
StudentEmail:
AreaofConcern:
Disruptivebehavior Possibleemotionalissues
Disturbingbehavior Suddenchangeofinmood,behavior,demeanor
Other
PleaseClarify(Includeonlydetailed,factualinformation):