ALLPS Application

This link can also be found at: www.bit.do/allps500

Agee Lierly Life Preparation Services (ALLPS) program serves as a short or long-term intervention to help students transition successfully to traditional schooling and beyond. While student/parents may decline placement at ALLPS, a committee of staff members may overrule and recommend placement based on the student’s efforts to succeed.

Student ID:

all ID's start with 7203.....(if you do not have one enter 0000)

This is a required question

Student LAST name:

This is a required question

Student FIRST name:

This is a required question

Student current GRADE level

This is a required question

Parent name

This is a required question

Select how you prefer to be contacted to schedule an appointment?

phone call
email
text message

This is a required question

Contact email (if any):

We will schedule meetings primarily via email contact.

This is a required question

Contact phone #: (please enter area code)

All efforts will be made to reach you via email.

This is a required question

What is student's enrollment classification?

This is a required question

REFERRING Person: Please enter the name and relationship to the student.

For example, John Doe, Counselor

This is a required question

Referring Person: list email or phone if you are not the student or guardian

This is a required question