Student Academic Probation Acknowledgement Form
Student Information
Full Name
Student ID
Email Address
Program/Major
Acknowledgement
I acknowledge that I have been placed on academic probation. I understand the requirements and conditions associated with my probation status, and have read the academic probation policy provided by the institution.
Student Statement
Briefly explain the circumstances that led to your probation status and your plan to improve your academic standing:
Signature
Student Signature
Date