VIRGINIA MILITARY INSTITUTE
Lexington, Virginia
Date : _________________
SUBJECT: Report of Academic Delinquency
TO: The Dean of the Faculty, through Head of Department
1. Cadet ________________________________________ has been neglectful of
his academic duties in (course
number and title) _______________________________
having on (date) _____________________________ failed to:
2. Further explanation (if necessary):
3. This is (is not) the first official report of academic delinquency made by me
concerning this cadet during the current term.
Signature:__________________________
Title: _____________________________
1
st
Ind.
TO: Dean of the Faculty Date: _________________
Recommendation
:
Signature: _________________________
Head of _________________ Department