Student Assistance Program Referral Form
The Student Assistance Program (S.A.P.) is a state mandated program to identify and assist students. Students are referred regarding problem behaviors such as a decline in grades, suspected drug use or behaviors that inhibit learning. Anyone may make a referral. Referrals can be made anonymously except in the case of teachers or staff. It is expected in their professional capacity that teachers and staff identify themselves when making a referral. This information is confidential and not shared with the student.
Student's LAST Name:
Enter the student's last name
Student's FIRST Name:
Enter the student's first name
Select the student's building
East Junior High School
Select the student's grade
Select what best describes relationship with the student
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This form was created inside of Pocono Mountain School District.
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