MCOE Alternative Education Schools, CCSPP, Resource Center Referral

The Monterey County Office of Education (MCOE) was awarded a California Community School Partnership Program (CCSPP) implementation grant to integrate the community school framework at the Salinas Community School. The community school framework aims to provide additional services for students, families, staff, and the surrounding neighborhood to ensure students are successful at school and beyond. Services can include additional support in their academics or services to meet their social emotional needs such as access to food, physical and mental heath as well as legal services just to name a few. 

The following is a referral form that will help us identify students and families who may be in need of additional services.

Information will be reviewed by our staff and then forwarded to the appropriate agency to best assist the student/family. Our staff will also provide follow ups with families.

This information is confidential and will only be seen by school or district employees directly involved with you or the student’s educational program.

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Date  *
MM
/
DD
/
YYYY
Person Completing Referral and Title
Student Name  *
Student Last Name  *
Student ID (optional)
Site  *
Grade  *
Student Address 
Student City
Student Zip Code 
Parent/ Caregiver/ Adult Student First Name  
Parent/ Caregiver/ Adult Student  Last Name  
Phone Number 
Language Spoken at Home 
Clear selection
Has the student been identified in any of the following:
Clear selection
Reason for Referral: *
Required
Please list any other concerns, symptoms, or observations:

Please list any interventions or services that the student/ family has been provided (i.e. after school interventions, mental health, etc.):

Please list any barriers that the student/ family may face when accessing services (i.e. transportation, language, work schedule, etc.)
Thank you for completing the referral form!
Our Community School CCSPP Coordinator will follow up! If you need immediate assistance please contact Veronica Lewis at 831-783-5277
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