Self-Report Referral (Retention "Selfie")
If you have a concern and you want to speak with us about that, let us hear from you. Our conversation will be treated with care and respect. You have a story and we want to hear it.
What is your first name? *
Given name - no nicknames, please.
Your answer
What is your last name? *
Your answer
What do you prefer to be called?
For example, your name is Rebecca but you prefer Becky.
Your answer
What is your e-mail address? *
Your answer
What is the best phone number to use in order to reach you? *
Your answer
How would you prefer to be contacted by the Retention Office? *
Required
Is your main reason for contacting us: Academic Concerns? *
Please mark the most appropriate categories.
Required
Is your main reason for contacting us: Personal Issues? *
Please mark the most appropriate categories.
Required
Is your main reason for contacting us: Financial Issues? *
Please mark the most appropriate categories.
Required
Briefly tell us more information regarding your reason for contacting us. *
This will help us better understand the situation and perhaps gather some information before we respond to you.
Your answer
Are you considering leaving MSU?
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