Academic Plan Of Action - Extension Requests
The purpose of the academic action plan is to provide an action plan for completing course work that is either anticipated to be missed or that has been missed. In addition, there are also situations where an assignment was submitted and a score of less than 60% was earned. For all of these situations, the plan will provide the necessary communications that will be needed for approval for turning in assignments and also to help you get back on track towards success within the course.

In addition, please be sure to identify assignments to include discussions with a "0" and list assignment below.

Student Name *
Your answer
Student Number *
Your answer
Email Address *
Your answer
Phone *
Your answer
Which Instructor are you submitting this request for? *
Please only submit one Extension or Plan of action request per class.
Course Number *
Which of the following statements best fits your situation? *
Would you like to book an appointment with your instructor? *
Would you like to have a tutor for this course? *
Tutor Requests: * Prior to Tutor approval, please book an appointment with Instructor
How Many assignments do you need a plan or extension for? *
List All Assignments and next to the assignment place the date that you plan to submit the assignment by: *
Example: Assignment WK2 - by: 1/31/2013, Discussion WK2 - by: 1/31/2013
Your answer
Provide Notes for Support needs if needed relating to the Assignments:
Your answer
Student Comments: *
Please provide any additional comments or questions.
Your answer
Approval Status *
If you are requesting an extension beyond the course due date, the assignment extension will not be approved, you will need to submit a request for an incomplete, use this link:
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service