B.A.R.K Application
Summer Reading Improvement Program(B.A.R.K) Parent Referral Form
Today's Date *
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Student's Name *
Your answer
Student's Birthdate *
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DD
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YYYY
School *
Current Grade *
Your answer
Current Classroom Teacher's Name *
Your answer
Give a brief description of the student's reading difficulties *
Your answer
Parent/Guardian Name *
Your answer
Home Address *
Your answer
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