DEFICIENCY REPORT
*Denotes required fields.
*
Semester:
Spring 2009
Summer 2009
Fall 2009
*
Type:
Mid-Term
Final
*
Student Number:
*
Student First Name:
*
Student Last Name:
*
Course Number:
*
Course Grade:
D
F
*
Name of Instructor:
Factors contributing to deficiency (check all that apply):
Poor test grades
Poor Attitude
Lack of effort
Lack of ability
Excessive employment
Failure to hand in work
Poor attendance
Deficient in reading and/or written & oral English
Comments: