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)
Email address *
Person making this referral *
Your answer
Today's Date *
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Student Name *
Your answer
Grade Level *
Was the Parent or Guardian Contacted? *
Type of Parent Contact *
Required
Date Parent Contact Attempted or Made *
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YYYY
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