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School Reference Sheet (to be completed by case manager)
This page must be completed and submitted or mailed to Janice Yetter, Department of Special Education, 5451 Beaverkill Road, Columbia, MD 21044, by March 1, 2018
REFERRAL SOURCE INFORMATION:
Days Absent: This year
Days Absent: Previous year
Days Tardy: This year
Days Tardy: Previous year
Comments about attendance:
Comments about school or work performance:
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Title and Phone Number:
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