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CARES Referral
We CARE
about your student's wellbeing and want to support you in addressing identified barriers to your student's success. Thank you for taking the time to complete this referral form.
Nos importa el bienestar de su estudiante y queremos brindarle el apoyo necesario para poder ayudarlo a superar los obstáculos que puedan estar afectando su rendimiento académico.
Gracias por tomarse el tiempo para completar este formulario de referencia.
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Student First Name
*
Your answer
Student Last Name:
Apellido del estudiante:
*
Your answer
Grade Level or Program:
Grado ó programa:
*
Choose
11
12
Diploma Access
Downey Adult Transition (DAT)
Woodruff Academy
Who is the individual making this referral?
Quien esta llenando este formulario/ referencia?
*
Student / Estudiante
Parent/Caregiver / Padre o tutor
Staff / Personal de la escuela
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