Aloha Learning Lab Referral
Aloha Club should only be used as a last resort for the student to complete work. Form should be completed by TOR.
Student Name *
Your answer
TOR *
Required
Date *
MM
/
DD
/
YYYY
Grade *
Student owes work for : (check all that apply) *
Required
Is the student at risk of failing? *
Was work offered during earned times? (List dates & result) *
Your answer
Was work sent home? (List dates & result) *
Your answer
Describe any other attempts made to the student to complete work? (Ex. Fieldhouse privileges removed, etc) *
Your answer
List exact work to be completed in Aloha Learning Lab (include teacher work should be returned to) *
Your answer
Submit
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