First Name: Last Name: TechID: Major: Advisor: Last time you had contact with your advisor: / / Factors Affecting Your Academic Success Check the items that have been a problem for you. Personal Anxiety Financial Problems Factors: Children Loneliness/Isolation Childcare Unresolved problems Transportation Change in relationships Spouse/Partner Too many commitments Extended family Clash between school & work Lack of confidence Clash between school & family Other: College Classes too long No opportunity for involvement with others Factors: Classes too small or too large Inadequate facilities for studying Campus values differ from yours Lack of access to advisor Problems with instructor(s) Inappropriate advising Instructors-inconvenient office hours Lack of knowledge of tutoring services Lack of computer access Lack of knowledge of university policies and procedures Other: Learning No interest in a particular course Courses do not fit career goals Factors: Courses unavailable when needed Lack of academic confidence ESL Difficulty taking tests Other: Approach to Poor follow through Unsure about what is important Cramming before tests Academic Concentration easily broken Little time to review Progress: Unsure how to study course materials Material quickly forgotten Trouble understanding textbooks Unexpected questions on test Other: Charting the Course for Academic Recovery List the top 3 factors that have most affected your academic success. Ex: Trouble getting to class on-time 1. 2. 3. Continue to next page
First Name: Last Name: TechID: Major: Advisor: Last time you had contact with your advisor: / / Factors Affecting Your Academic Success Check the items that have been a problem for you. Personal Factors: Anxiety Financial Problems Children Loneliness/Isolation Childcare Unresolved problems Transportation Change in relationships Spouse/Partner Too many commitments Extended family Clash between school & work Lack of confidence Clash between school & family Other: College Factors: Classes too long No opportunity for involvement with others Classes too small or too large Inadequate facilities for studying Campus values differ from yours Lack of access to advisor Problems with instructor(s) Inappropriate advising Instructors-inconvenient office hours Lack of knowledge of tutoring services Lack of computer access Lack of knowledge of university policies and procedures Other: Learning Factors: No interest in a particular course Courses do not fit career goals Courses unavailable when needed Lack of academic confidence ESL Difficulty taking tests Other: Approach to Academic Progress: Poor follow through Unsure about what is important Cramming before tests Concentration easily broken Little time to review Unsure how to study course materials Material quickly forgotten Trouble understanding textbooks Unexpected questions on test Other: Charting the Course for Academic Recovery List the top 3 factors that have most affected your academic success. Ex: Trouble getting to class on-time 1. 2. 3. Continue to next page
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