You must have JavaScript enabled to use this form. 1 Start 2 Complete Today's date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20242025202620272028 Scholar's First Name * Scholar's Last Name * Scholar's UC Merced Email * Year in the program * Second Year Other Lead Scholar Name * Lead Scholar's UC Merced Email * Which meeting is this for the scholar? * First LS Meeting Second LS Meeting Other Which of the following requirements have you already completed? (Please select all that apply) * Pro-Staff Meeting #1 Lead Scholar Meeting #1 Lead Scholar Meeting #2 Workshop #1 Workshop #2 1 Professional Development 1 Faculty Reception 1 Social Notes and Resources (This will be emailed to the Scholar) * Student of Concern Form Student of concern forms are submitted when a student exhibits signs of distress such as behavioral, academic, or interpersonal concerns. This can include panic reactions, sudden decline in grades, and self-disclosure of family problems, etc. * Yes, a student of concern form has been filled out for the scholar A student of concern form will be submitted for the scholar N/A Lead Scholar will follow-up through email with their supervisor if a Student of Concern Form was submitted. The following is the direct link to the Student of Concern Form: https://ucmerced-advocate.symplicity.com/care_report/index.php/pid684882? Internal Notes (Concerns, Recommendations, Advice/Resources Given) * Leave this field blank
