TSC Section 504 Online Referral Form (SY22-23)
This form is used to make all Section 504 referrals. Please complete the form and submit it. Once the referral is received, the Coordinator will process the referral. Generally, the Coordinator processes referrals on Fridays.

PARENTS: Please contact your school's Designated Person before completing this form. He or she can help you with the process. This will avoid delays by ensuring you make the correct referral.

TEACHERS: Please contact your buildings Designated Person to discuss the referral process before submitting this form.
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Email *
Your Name *
Relationship *
Student Name *
Current Grade *
School *
Referral Type *
Referral Reason *
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Tippecanoe School Corporation.