Tutoring Referral Form

This form is intended for LSUE instructors to submit when a Pathways to Success student has scored below a C average (or 70%) on course work. 

IMPORTANT: This form should be submitted immediately following the grade was earned so the Student Success Center staff can reach out to the student and intervene. For early alert systems to be successful, they must be EARLY!

Course Work Information:

Please provide some information about the course work on which the student performed below average.
Reason for performance:
To the best of your knowledge, what factor(s) do you believe contributed to this student's poor grade. Check any that you believe may apply.



Student Success Center

P.O. Box 1129
2048 Johnson Hwy
Science Building, Room 146
Eunice, LA 70535

Phone: 337-550-1206
Email: studentsuccess@lsue.edu