Peru State College
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Early Alert Cancellation Form

 
Student's NUID: (Required to ensure correct identification)
Student's Last Name:
Student's First Name:
Instructor Name:
Instructor NUID:
Course:
Reason for Cancellation:

Comments:

(limit 255 characters. Comment will be included in email to student only if the cancellation is due to improvement and the comment seems to be intended for the student.)

 

Type the characters you see in the picture below:

security code


 

 

(Submitting this form generates an email to Dan Fender, Licensed Student Counselor, at DFender@peru.edu and to Phyllis Dierking, CATS Office Assistant, at PDierking@peru.edu.)