This form is to be used by EAS teachers or staff to refer students for support services.
Please fill out this form completely and accurately to ensure we can serve the referred student appropriately.
This form will be reviewed by the College & Career Technician. The teacher/staff member and the student will be contacted via email within 3-5 business days.
If students would like to request services for themselves, please have them use the "Student Request for Support Services" form listed under the "Student Supports" menu on our website.