Fillable Wichita State University - FCLAS Instructor Academic Concern Form

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Wichita State University - FCLAS Instructor Academic Concern Form

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Fairmount College of Liberal Arts and Sciences
Report of Academic Concern Form
(Instructor use only)
Type of Academic Concern Grade Appeal
Instructor Concern
Other
Prior to scheduling a meeting with a Dean related to an academic concern, students must have met with the
Instructor. Please indicate the action taken and resolution.
Prior Administrative
Meetings Held
I have met with the student and the issue is resolved.
I have met with the student and the issue was not
resolved. I referred student to the Department Chair.
Other
Instructor Information
Instructor Name
Department
Course Number
Course Name
Preferred Email
Preferred Telephone Number
Preferred contact email office phone cell phone
Student Information
First Name
Last Name
WSUid
Please describe the incident
Please outline the
resolution, if achieved.
Additional Notes (For office
use only)
Date
Thank you for submitting your academic concern to the Fairmount College of Liberal Arts and Sciences Dean's
Office. If we fail to acknowledge receipt of your submission within 72 hours, please e-mail
V. Kaye Monk-Morgan, Assistant Dean for Students at kaye.monk@wichita.edu.
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Wichita State University - FCLAS Instructor Academic Concern Form

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Completed 30 May 2020

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