PAES Lab Referral 
This is the first step in the PAES Enrollment Process.  By completing this form, you are identifying a student you believe would benefit from participation in the PAES Lab.  Once the form is complete, the PAES Program Coordinator will review the information as well the student's IEP and evaluation.  You will then be contacted within a month to discuss the student's possible participation in the lab.  Completing this form is not a guarantee into the program. 
Email *
Student Name *
Grade *
School  *
Case Manager *
Disability Category *
Required
What related services does the student currently receive:  *
Required
Please explain why you believe the student would be a match to for this program. *
Please explain the student's strengths positive attributes.  *
Please explain the struggles the student currently has. *
Please describe any work skills the student currently has.  *
Please describe any work skills you would like the student to gain.  *
Please describe the student's current level of career awareness.  *
Please provide any other relevant information or data *
Areas of difficulty or struggle for the student *
Required
Does the student struggle with behaviors?  If so, please explain *
When would you like the student to start?  *
What time of day would you prefer the student attend the lab?  *
Required
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