PLEASE COPY AND PASTE TO SEND BY EMAIL TO HYMAN@COOPER.EDU

THE COOPER UNION CENTER FOR WRITING AND LANGUAGE ARTS
PROFESSOR REFERRAL FORM ONGOING SESSIONS

STUDENT'S LAST NAME, FIRST NAME: _____________________________________________________________________

SCHOOL: ________________________________________________________ YEAR: ________________________________

YOUR LAST NAME, FIRST NAME: __________________________________________________________________________

YOUR EMAIL: ______________________________________ YOUR PHONE # (OPTIONAL): __________________________

HOW MIGHT WE MOST EASILY CONTACT YOU TO DISCUSS THIS STUDENT'S WORK? ___________________________

HOW OFTEN WOULD YOU LIKE TO BE SENT REPORTS ON THIS STUDENT'S PROGRESS? _______________________

NAME OF COURSE: ______________________________________________________________________________________

HOW OFTEN WOULD YOU LIKE THIS STUDENT TO ATTEND SESSIONS? ___________________ HOURS PER WEEK

ARE ONGOING SESSIONS RECOMMENDED OR REQUIRED FOR THIS STUDENT? _______________________________

WOULD YOU LIKE TO BE NOTIFIED IF THIS STUDENT MISSES A SCHEDULED SESSION? ________________________

PARTICULAR AREAS NEEDING ATTENTION (PLEASE CHECK ALL THAT APPLY):

_____ BASIC GRAMMAR                                   _____ ESSAY STRUCTURE                            

_____ WORDINESS                                           _____ CLARITY                             

_____CONCLUSIONS                                        _____ ARGUMENTS                       

_____ ESL ISSUES                                             _____ PARAGRAPHING

_____DEVELOPMENT OF IDEAS                      _____ SENTENCE STRUCTURE           

OTHER AREAS NEEDING ATTENTION (PLEASE BE AS SPECIFIC AS POSSIBLE):

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