Academic Probation Contract & Self-Assessment

Please allow 15-20 minutes to complete this form. You’ll be asked to share basic information about yourself, engage in self-reflection, and answer a series of questions related to the personal assets you bring to college, including your internal and external resources. This information will be used by your Bobcat Success Coach to help you develop a personalized plan for your success at Peru State College.

By completing and submitting the Academic Probation Contract and Self-Assessment, you agree to abide by the terms herein. This form will be treated as a student record and governed by applicable FERPA regulations.

Page 1 of 6 - Basic Demographics and Contract Terms

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Name Name * First Last
Preferred Phone Preferred Phone * - ### - ### ####
Campus Email Address for Returning Student OR
Current Email Address for Transfer Student *
Class Standing *

Class Standing FR SO JR SR New Transfer Student

If you selected New/Transfer Student please ignore the next four questions and hit Continue
For which semester or term will you be enrolling? *
Academic Probation Status *
What type of courses do you plan to take? *
What is your major (program of study)? *
TERMS OF YOUR CONTRACT

As a condition of your enrollment, you must indicate your agreement to abide by the following terms by checking the box next to each. *

TERMS OF YOUR CONTRACT

As a condition of your enrollment, you must indicate your agreement to abide by the following terms by checking the box next to each. Probationary Enrollment Limits: To ensure enough time to focus on your courses, you may enroll in a maximum of 15 total credits within a full semester, including a maximum of two eight-week courses in the same eight-week term. You may enroll in a maximum of seven credits within a summer term. It is your responsibility to communicate these enrollment limits to any college representative advising you on course selection. To exceed these limits, you must have permission from the Vice President for Academic Affairs.
*

Participation in Academic Monitoring: To help you stay on track academically, you are expected to maintain direct communication with your instructors, participate in your courses, refer to course syllabi for grading criteria, and seek clarification or guidance as needed to monitor your own academic progress. You will meet with your Bobcat Success Coach three times during the probationary semester. Your Success Coach may request progress reports from your instructors.
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.

Academic Probation Contract & Self-Assessment

Academic Probation Contract & Self-Assessment

Page 1 of 6 - Basic Demographics and Contract Terms