Academic Coaching Appointment Request Form

Thank you for requesting an Academic Coaching appointment through the Office of Student Success. Please fill out the questions here, which will assist us with preparing for your appointment and selecting an appointment time that works for you. Appointments are generally one hour and will be facilitated by a professional staff member from the Office of Student Success or a trained peer Academic Coach. Once submitted, a staff member will follow up with you via email to confirm an appointment time. *

Great, I'd like an appointment. I have questions first. (If you have questions, please feel free to email Lesly Clay at clayl@union.edu.)

Name*

First Name

Last Name

Email*

Phone*

Who referred you to the Office of Student Success?*

What is your current year and/or academic progress at Union?*

First Year Student Second Year Student Third Year Student Fourth Year Student

Other:

What is your major and minor (if applicable/if known)?*

What classes are you currently taking?*

Please tell us what topics we may be able to assist you with. You're welcome to check as many boxes as you'd like.*

Managing My Time / Time Management Techniques Motivation, Concentration, and/or Procrastination Test Preparation Techniques Specific Study Skills (Textbook Reading, Note Taking, Etc.) Advising Information (Please note, a referral to your Advisor may be needed also.) Communicating with Instructors Getting Involved On Campus Campus Resources

Other:

Please give us details about what topics you would like to discuss with us more or any specific problems you’re having (this response is optional).

If you have a preference related to who you would like to meet with - a specific peer coach, a professional staff member, etc. please list that here (optional).

What days and times will work best for you to meet with us? This information will be used to confirm an appointment time with you. If you are able, please list multiple days/times. *

From here a staff member will follow up with you to confirm an appointment time and/or discuss availability in more depth. Appointments can be over Zoom and/or in person. Your academic coach will discuss this with you. If you have questions in the meantime, please feel free to email Lesly Clay at clayl@union.edu.

I understand. I have questions and will reach out instead.