Special Services

Instructor Contact Form

For each online class, follow the instructions below. Please Note: Instructor contacts are due mid-March for Spring and mid-October for Fall semesters.

Step 1

Open a blank email and copy and paste the content in the yellow box below into the BODY of the email. Once you have pasted the content, fill out the top portion of the table that is the Student/Class Information Section. Students who have plain text only email editors should use the modified text version provided at the bottom of this page.

To copy and paste, click with your mouse button before the S in the word Student, and then hold the mouse button down and drag it all the way to the bottom of the table after the e in the word Name after "Instructor's Name." You can then go to Edit > Copy in the browser file menu, or hit CTRL+C on your keyboard. To paste, go to your email window and click in the body section and do CTRL+V or go to Edit > Paste on the file menu.

Student/Class Information Section
Student Name	Enter your name here
ID#	Enter your ID number
Class	Enter the Class name
CRN#	Enter CRN#
Student Email	Type your Email address
Comments
Faculty Feedback Section
Please complete the EOPS Instructor Contact form below. To do so, reply to the student and fill out the information below and then send the email to the student. It is the student�s responsibility to bring a copy to their counselor. Please do not forward the form to anyone except the student. If you have any questions, please contact the Special Services Office at (760) 384-6250. Thank you. *Please reply to student as soon as possible.
Progress	____Good ____Satisfactory ____Poor
I recommend you	____Keep up the good work! ____Contact the LAC (760) 384-6302 for tutoring
Comments
Instructor's Name

Step 2

Send the email to your instructor and use "EOPS Instructor Contact Form" as the Subject line. Send a copy of the email to yourself as an additional record of when you contacted your instructor.

Step 3

When you have received the completed response from your instructor via email make a print out of their response.

Step 4

When you have all your instructor contacts (online and campus classes) completed, make an appointment with your Counselor to review.

Remember to bring copies of all instructor contacts to your appointment.
This is one of your EOPS required counseling contacts.

Plain Text Version: For students with Plain Text only email editors

Student/Class Information Section
____________________________

Student Name: Enter your name here
ID#: Enter your ID number
Class: Enter the Class name
CRN#: Enter CRN#
Student Email: Type your Email address
Instructor Email: Type Instructor's email address
Comments: (List any special ID information your instructor requires in the subject line of an e-mail)

Faculty Feedback Section
____________________________

Please complete the EOPS Instructor Contact form below. To do so, reply to the student and fill out the information below and then send the email to the student. It is the student�s responsibility to bring a copy to their counselor. Please do not forward the form to anyone except the student. If you have any questions, please contact the Special Services Office at (760) 384-6250. Thank you. *Please reply to student as soon as possible.

Progress
____Good ____Satisfactory ____Poor

I recommend you
____Keep up the good work!
____Contact the LAC (760) 384-6302 for tutoring

Comments

Instructor's Name:

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