Unique Learning System- Request for License and/or Training
ESE teachers who teach in a self-contained, ESE class to students who are on a modified curriculum should use this form to make all requests for Unique Learning System support. This form will be used to identify teacher needs and outline support to be provided. If you have questions or concerns, you may contact either Angie Torres (Supervisor for Autism Spectrum Disorder Program) or Reagan Chalmers (Supervisor for Intellectual Disabilities Program).
What is your name? *
Your answer
What is your employee number? *
Your answer
Please write your email here: *
Your answer
What is the name of your school? *
Your answer
What kind of support would you like? *
Do you need to change grade level band? *
If you answered yes above, please indicate new band that you need.
What grade(s) do you teach? *
Your answer
What subject(s) do you teach? *
Your answer
Do you teach in a self-contained, ESE class? *
Are all of the students in your class on a modified curriculum? *
Is there anything not mentioned here that you would like to add?
Your answer
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