Academic Probation Instructor Feedback Form
Student Name
Student ID
Instructor Name
Course Title
Semester
Attendance
Attendance Performance
Excellent
Good
Fair
Poor
Comments on Attendance
Academic Performance
Assignment Completion
Always
Frequently
Sometimes
Rarely
Comments on Academic Performance
Participation
Class Participation
Active
Moderate
Minimal
None
Comments on Participation
Recommendations
Instructor Recommendations for Student Improvement