Mustang Referral Form

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Mustang Referral Form

Concerned about a current SMSU student? The following referral form is to be used by SMSU service faculty/staff and students. Teaching faculty may utilize this form outside of designated reporting time frames (week 3 and week 7 of each semester); however, ask that they follow early alert procedures through Hobson's Retain when the survey is made available to them. For more information, please click on the following link: http://www.smsu.edu/campuslife/studentsuccess/?id=7459 

Please fill out the form to the best of your ability. Note: In order to help the student with his/her needs, the student will be informed of who referred them.

Referral Form
University Classification of
Student (if known):




I am concerned with this
student because of the following
reason(s) - check all that apply: *









Story Image Pat Carmody is Cowan Award Winner

Registrar Pat Carmody is the 2017 Cowain Award Winner, and will receive a special medal during Commencement exercises May 6.

Story Image Dene Kay Thomas is Commencement Speaker

Dr. Dene Kay Thomas, president of Fort Lewis College and an SMSU alumna, is this year's Commencement speaker

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Southwest Minnesota State University

1501 State St. Marshall, MN 56258
1-800-642-0684
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We are an affirmative action / equal opportunity university.
Southwest Minnesota State University is a member of the Minnesota State system.