Student Advocate Intake Form
Date of Initial Contact:
*
-
Month
-
Day
Year
Date Picker Icon
Type of Contact:
*
In-Office
Phone
E-mail
Mail
Student Full Name
*
First Name
Middle Name
Last Name
Student A#
*
Your Name (if not student):
First Name
Last Name
Relationship to Student:
Status:
*
Freshman
Sophomore
Alumni/Former Student
Type of Student:
*
Current
Re-Admit
First-Time
Prospective
Dual Enrollment
Non-Credit
Other
Primary Campus:
*
Decatur
Huntsville
Both
Alabama Center for the Arts (ACA)
Online
Primary Phone:
*
Primary E-mail:
*
Please tell us your reason for contacting the Student Advocate Office (check all that apply):
*
Admissions
Advising
Financial Aid
Instructional
Graduation
Disciplinary
Student Activities
Personal/General
Business Office
Disability/ADA
Student Services
Other
Please elaborate on these issues:
Admissions Issues:
Admission/Application Process
Registration
Transcript Issue
Drop/Add Issue
Bankruptcy/Course Forgiveness
Probation/Suspension
Customer Service
Withdrawal (Medical, other)
FERPA
Transient Student Issue
Other
Advising Issues:
Advising
Orientation
Career Services/Job Placement
Placement Test
MAPS Plan
Recruitment
Campus Tour
Customer Service
Other
Financial Aid Issues:
Pell Grant/FAFSA
Student Loan
Scholarship
Application/Paperwork
Financial Aid Appeal
Veteran Issue
Customer Service
Other
Instructional Issues:
Faculty Complaint
Program Complaint
Grade Appeal
Course Offerings
Reinstatement
Class/Medical Withdrawal
Incomplete
Online/IT Issue
Contact Instructor
Other
Graduation Issues:
Requirements
Costs/Fees
Ceremony Issues/Questions
Deadlines
Regalia Questions
Other
Disciplinary Issues:
Faculty Dispute
Grade Dispute
Plagiarism
Discipline Hearing/Follow-up
Grievance Process
Cheating
Code of Student Conduct
Sexual Harassment
Bullying
Other
Student Activities Issues:
Club/Organization Information
Event Information/Dates
Application Process for Clubs/Organizations
Other
Personal/General Issues:
Transportation
Childcare
Housing
Directions to Class
Physical/Emotional Problems
Counseling Request
Insurance Inquiry
Other
Business Office Issues:
Tuition Payment
Parking Decal
Refund
Payment Plan
Customer Service
Other
Disability/ADA Issues:
Accommodations
Paperwork/Application
Book Loan Program
Customer Service
Other
Student Services Issues:
Tutoring
Service Learning
Honors Day
Student ID
Customer Service
Other
Other (Please explain)
Submit
Should be Empty: