(needed in triplicate)
Name
of Student: _________________________________________
UMS
(WISER) number: ____________________________________
1.
Date
of Conference:
_____________________________________
(If conference has not been possible, please explain
why)
2. Please list below a description of the work to be made up, a plan and a timetable. Include date that has been agreed upon for completion. If the instructor is not certain to be in residence at the time of completion, explain what provisions have been made.
_________________________________ _________________________________
signature of instructor signature of student