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LCC Success Coach Referral Form
This form is for faculty, staff, and LCC stakeholders to refer students who may need additional support and resources to academic success coaches.
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Your Email Address
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Your Phone Number
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Student Name
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Student Banner ID #
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Student's Major
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Student Email Address
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Student Phone Number
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Why are you referring this student to an academic success coach?
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How do you know this student?
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Is the student aware that you are referring them?
Would you be interested in being part of this student's support network?
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