Alternative Education Online Referral form: Alternative Education Online Referral form 1. * Student's name: 2. * Referring party's relationship to student: Referring party's relationship to student: School Counselor School Adminstrator Parent or Guardian Student (Self Referral) School Nurse School Psychologist Teacher Other 3. * Student's graduation class - year of: 4. * Student's school counselor: Julie Castagna Marcia Piette Laura Kuether 5. * By Wisconsin state statute 118.153, a student is considered "legally at-risk of nongraduation from high school" if they have two of the following qualifiers. Please check as many as apply to the student. (1 required) By Wisconsin state statute 118.153, a student is considered "legally at-risk of nongraduation from high school" if they have two of the following qualifiers. Please check as many as apply to the student. Habitually truant Adjudicated delinquent Teen parent More than one year behind in credits Two or more years behind in basic skills Student has no qualifiers to be considered 6. Sometimes a student might be appropriate for Alternative Education for reasons beyond the qualifiers of being legally "at-risk." Please provide all information you wish to be considered in the referral process. Any information provided in this portion will remain confidential within the Alternative Education department. 7. * Please list academic, behavioral, motivation etc. interventions that have been utilized for this student. Check as many as apply. (1 required) Please list academic, behavioral, motivation etc. interventions that have been utilized for this student. Check as many as apply. ELL Services RTI Small Study Hall Counseling Groups Tutor Curriculum Differentiation EEN Services 504 Modification Plan Middle School At-Risk Program Tuesday Advisory No interventions have been utilized Homebound Instruction Student is a transfer student 8. * Describe the Alternative Education services that you think would most appropriately support this student? * Enter Your Email Address:
Left Navigation Site Search About Us Contact HHS Staff Departments Partnership in ACP Alternative Education World Language English Department Music SIRS Researcher (Database) Athletics Activities & Clubs Parent & Student Information Skyward Family & Student Access Fitness Center