Referral for Pupil Appraisal Services 2020-2021
In emergency/crisis situations, please contact Senecca Boudreaux at 225-210-4925. Please allow up to 24 hours during the work week for a response from Pupil Appraisal.
* Required
School Site:
*
Choose
St. James High
Lutcher High
Vacherie Elementary
Gramercy Elementary
Sixth Ward Elementary
Paulina Elementary
Cypress Grove Montessori
Science and Math Academy
Alternative School
Person completing form- Name and Contact Information
*
Your answer
Meeting Date and Time, if already scheduled. Please give at least three days notice:
Your answer
Pupil Appraisal is needed for:
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SBLC/Parent Referral for Special Education
Academic intervention consultation
Consultation for Tier 2 Behavior Support Plans for a Special Education student (High Schools Only)
Referral for an Initial Functional Behavior Assessment/Behavior Intervention Plan for a Special Education student or for those students going through the SBLC process
Manifestation Determination Review meeting
SBLC/Parent Referral for Gifted or Talented
Special Education student is not making progress and the IEP team is requesting a significant change of placement.
New Special Education student has enrolled in the parish.
Transition meeting for a Special Education student to the Alternative Center.
New concerns for a Special Education student
Consultation to review any outside evaluations (e.g., private evaluations, medical evaluations, etc.).
Consultation from Related Service Provider (OT and PT) due to Motor Concerns
Other:
Required
Student Name:
*
Your answer
Is the student a ___________________ student.
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Regular education
Special education
504
Pupil Appraisal sent (FOR OFFICE USE ONLY):
Tonya Johnson
Adele Brown
Heidi Trosclair
Sandra Guidry
Honore' Conish
Carol Dawson
Anissa Scott
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