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Please fill out a separate report for each student you coach. Thank you so much for committing to student success at TJC!

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* 1. Please enter the student's name and A#.

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* 2. Through what modality did you meet with the student? (Choose all that apply.)

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* 3. Enter the date that you met with this student.

Date
Time

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* 4. Does the student need guidance with any of the following? 

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* 5. Does the student intend to set a future meeting or did the student set a future meeting?

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* 6. Please provide concise notes about your meeting with the student. Please include items such as student concerns, solutions provided, and other next steps.

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* 7. If you referred the student to other resources (i.e., other departments), please provide those resources.

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* 8. By entering my A# in the blank, I acknowledge that this information is correct and accurate to the best of my knowledge.

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