ALLPS Application
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Agee Lierly Life Preparation Services (ALLPS) program serves as a short or long-term intervention to help students transition successfully to traditional schooling and beyond. While student/parents may decline placement at ALLPS, a committee of staff members may overrule and recommend placement based on the student’s efforts to succeed.

What is your last school of record? *
Student ID: *
all ID's start with 7203.....(if you do not have one enter 0000)
Your answer
Student LAST name: *
Your answer
Student FIRST name: *
Your answer
Student current GRADE level *
Parent name *
Your answer
Select how you prefer to be contacted to schedule an appointment? *
Contact email (if any): *
We will schedule meetings primarily via email contact.
Your answer
Contact phone #: (please enter area code) *
All efforts will be made to reach you via email.
Your answer
What is student's enrollment classification? *
REFERRING Person: Please enter the name and relationship to the student. *
For example, John Doe, Counselor
Your answer
Referring Person: list email or phone if you are not the student or guardian *
Your answer
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