Student Success Team (SST)
Utilize this form to start the SST process for students needing more support. This form should only be completed after all teacher interventions have been exhausted and another level of support is required.
Teacher (Last Name, First)
Do you wish to participate in the SST meeting when student is discussed?
Describe the strengths of the student.
Often Absent, but not chronic
Check the boxes below that the student may be having difficulty with while in your presence.
Check all interventions you have completed prior to issuing this SST referral?
Personally spoke to student individually
Personally spoke to parent over the phone or via email
Personally held a parent conference regarding student
Personally assigned tutoring afterschool in the library or at Saturday school.
Created behavior plan for student in my classroom
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