Student Interaction Form
Please complete this form for each student following each interaction.
Guide Name
Keyword
Student Housing
Derby Complex (Ford, Haymaker, Moore, West)
Fraternity
Jardine Complex
Kramer Complex (Goodnow, Marlatt)
Off-campus
Smith/Smurthwaite/Clovia Scholarship House
Sorority
Strong Complex (Boyd, Putnam, Van Zile)
Student College
Agriculture
Architecture, Planning, & Design
Arts & Sciences
Business Administration
Education
Engineering
Human Ecology
Open Option
Date of Interaction
Type of Interaction
Meeting
Lunch/Coffee
Email
Phone Conversation
Activity/Event
What issues were addressed during your interaction? Please check all that apply.
Student Involvement
Joining a student organization
Campus events/activities
Greek life
Community service
Multicultural student services
N/A
Other (please describe)
Career/Major
Internships
Work / study
Career interests
Major / career exploration
N/A
Other topics (please describe)
Housing
Roomate conflict
Assignment issues
Facilities / fixit issues
Residence hall involvement
N/A
Other topics (please describe)
Freshman culture
Alcohol
Anxiety / stress / depression
Drugs
Financial issues
Finding their niche
Making friends
Time management
N/A
Other (please describe)
Academics (students with any academic issues should be referred to their academic college Dean's Office or academic advisor. This question is for tracking purposes only).
School based issues
Academic advising
Faculty
Tutoring
Technology
Registrar
Library
N/A
Other (please describe)
Were any other topics or questions discussed?
Yes
No
If yes, please describe
Did you refer the student to another office or department to address/solve any of the issues above?
Yes
No
If yes, to whom did you refer them and in what office?
Number of students at meetings
1
2
3
4
General thoughts or comments
Indicates Response Required