Request for Assistance (MS/HS) 2019-2020
This Request for Assistance form is to be used when a Staff Member would like to report a significant concern about a Student's Attendance, Behavior and/or Coursework. Student Empowerment Team (SET) Core Team members will receive email notification of your request after you submit the form. At the the next SET Meeting (Thursdays 8th and 9th periods), the Student will be assigned a Case Manager by the SET Core Team. The Case Manager will communicate directly with you to follow up. Thank you for taking the time to reach out to us! --- SET Core Team (Libo, KatieJo, Lisa, Vanessa, Jill, Jesse)
Person making this referral
Was the Parent or Guardian Contacted?
Yes, contact about the concern was made.
Contact was attempted but unsuccessful.
No, contact was neither attempted nor made.
Type of Parent Contact
Met in Person
Date Parent Contact Attempted or Made
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This form was created inside of Lyons Central School District.