TechnicalCollegeoftheLowcountry
StudentofConcernForm
ThisformgoestoTCL’sDeanofStudents’Officeduringnormalbusinesshours.Itisnotmonitoredafter
hoursonweekends,oroncollegedays.Shouldyouhaveimmediateconcernscallcampussafetyat
BeaufortCampus:5258301or9866971
(cell);NewRiverCampus:4706004or8124115(cell).Incase
ofanemergencycall911immediately.Ifyouprefertodiscussyourconcernorifthenatureofyour
concernisofasensitivenature,pleasecall5258219.
ContactInformation
YourName:
YourPosition:
YourEmail:
YourPhoneNumber:
Wouldyoulikeustocontactyoupriortocontactingthestudent? Yes No
StudentInformation
NameofStudent:
StudentIDnumber:
StudentPhone:
StudentEmail:
AreaofConcern:

Disruptivebehavior Possibleemotionalissues
Disturbingbehavior Suddenchangeofinmood,behavior,demeanor

Other
PleaseClarify(Includeonlydetailed,factualinformation): 