Winter Success Program Intake - Northwood University Forms

Name *

First Last

Student ID *

Email *

Phone number *

What is your status after Fall? *

First semester on probation
Dismissal Warning/Final Semester probation
Good standing but failed a class in Fall
Pended dismissal
I don’t know

What class did you fail in Fall? *

Because of the status indicated above, you will be required to participate in the Winter Success Program. *

I understand and agree

What year at Northwood are you? *

First year
Second year
Third year
Fourth year

Are you a student-athlete? *

Yes
No

What sport do you play as a student-athlete? *

In reflecting about your academic difficulties, what do you feel is a major contributor to your performance? *

Attendance
Test-taking anxiety
Procrastination
Note-taking
Submitting assignments on time
Time management

What is your GPA goal for Spring? *

(Three digits)

What action steps do you plan to take to repair your GPA in Spring?

Winter Success Program
Weekly Success Coach meetings
Skill development workshops
Faculty office hours
TLC
Other

Besides the Winter Success Program, what action steps do you plan to take to repair your GPA in Spring?

Weekly Success Coach meetings
Skill development workshops
Faculty office hours
TLC
Other

Who is your preferred success coach (if any)?

Please describe what "other" action steps you plan to take: *

Time Commitment *

The winter success program will meet virtually during the week of January 3-8, 2022.

Please read the time commitment statements below, and check where indicated.

Week of January 8 time commitment (approximately 4.5 hours per day)

There will be two sessions each day:

One in the AM from 10 a.m. to 11:20 a.m. (This session will be Real-Time Online/Bluejeans format)
In the afternoon you will also need to attend small group sessions; they will last approximately one hour.

You will also need to set aside two hours each day to complete the assigned tasks/homework. This breaks down to one hour of course prep, and one hour of homework.

Weeks 1-8 Spring Semester (approximately 2.5 hours per week)

Each week there will be required “small group coaching” sessions. This should be regarded as mandatory and treated like a real class session. Each session will be for approximately 45 minutes. In addition, there will be a graded success move assignment each week to complete that should take no more than two hours to complete.

I understand the Week of January 3 time commitment of 4.5 hours a day and will clear my calendar of other responsibilities at this time to be able to participate.
I will be on time for every session, and make sure I am communicating all technical issues with the facilitators.
I understand the Weeks 1-8 time commitment of 2.5 hours a week and will attend each session as planned.

Privacy *

Please read the statement of privacy and check the statements below.

This program serves all types of students who would like to improve their academic performance. For some, they choose to participate to take their academics to the next level. Others may be participating in this program based on their academic performance and as a required stipulation of a performance improvement plan. No matter your status in the program, facilitators will not mention any particular status unless you choose to disclose your own background.

In order for people to participate freely, all students will need to uphold the privacy of others. This is in keeping with our core values, integrity and institutional ethics. To be clear, it would be wrong to share information learned about your peers during the course of this program with others.

I understand that people participate in this program for a variety of reasons.
I understand that each reason is personal, and will not be shared by the facilitators unless disclosed by me.
I promise to uphold myself in a manner (before and after the program) that protects the privacy of my fellow students.

Required participation statement *

While I am opting into this program and it is not required of me, I intend to participate fully throughout intensive success week January 3-8 in order to set myself up for success and attend ongoing coaching sessions to keep me on track.

Email

This field is for validation purposes and should be left unchanged.