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SBHS Level II Attendance Referral
After completing this form, the student's school counselor and grade level administrator will be notified.
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* Indicates required question
Email
*
Your email
Your Name:
Your answer
Student's First Name:
*
Your answer
Student's Last Name:
*
Your answer
Student's Counselor:
*
Choose
Halina Gangi
Lindsey Hudson
Meg Hughart
Justin Pinard
Zac Poland
EST, 504, IEP, ELL?
*
EST
504
IEP
ELL
None
Required
Grade:
*
Choose
9
10
11
12
Name of course:
*
Your answer
Date of first contact to parent/guardian:
*
MM
/
DD
/
YYYY
Which parent/guardian did you speak with? Outcome?
*
Your answer
Any other contact with parent/guardian?
*
Your answer
Has the student attended Office Hours?
*
Yes
No
N/A (Advisory)
Description of the current situation with this student:
*
Your answer
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