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Student Success Check-in Request

In order to serve and resource students for success, the Student Retention Team (SRT) has set up this check-in request system for students, staff, and faculty at Central to utilize.  Please use this page to let the SRT know about any concerns that you may have about the challenges or well-being of a fellow student or yourself. Please note that this page should only be used to inform the SRT about issues or challenges that individual students are facing so that the SRT can follow up in an appropriate way with that individual.  There are other avenues available for students to give feedback about courses and the institution.  Information submitted is anonymous unless you choose to give us your name so that we can contact you if we have any further questions.

Important:  If you or someone you know is in crisis and it is an emergency, please call 9-1-1.  This form is not monitored 24/7 and is not to be used in cases of emergencies.
2. What is the nature of the concern you have (select all that apply): *This question is required.
3. Please select the nature of the Academic Issue (select all that apply):
3. Please select the nature of the Financial Issue (select all that apply):
3. Please select the nature of the Community Issue (select all that apply):
3. Please select the nature of the Personal Issue (select all that apply):