Detention at Madison Student Support Center
This will be a form that allows for temporary placement at Madison Student Support Center assigned by the Administrator from Bernard Long, Madison Sr. High, Madison Jr. High.
Email *
What is the name of the Administrator referring student? *
Name of Student *
Name of School *
Grade Level *
Does the student have an IEP? *
Reason for Referral *
Start Date of Detention? *
MM
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DD
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YYYY
End Date of Dentention? *
MM
/
DD
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YYYY
How many days will student serve suspension at MSSC? *
Transportation must be arranged for student to come to MSSC!  Google form must be submitted by 4:30 p.m.  The student must be aware that (s)he will be picked up at their house and go directly to MSSC.  If transporting herself/himself,  attendance is from 8 a.m. - 2:25 p.m. *
How will student be transported home *
Students Must have assignments for entire time while at MSSC! *
Uniform/dress code will still be enforce while at MSSC *
Required
List the student's address for pick up *
Submit
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