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At-Risk Counseling Referral Form Culver City High School 2007-2008 Referred By: Date of Referral: Student Name: Grade: Section I. Areas Of Improvement (Please check all that apply) Attendance Issues
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How to Fill Out Referral Form Academically At-Risk:

01
Begin by carefully reviewing the referral form and familiarizing yourself with the specific criteria for identifying academically at-risk students.
02
Pay attention to the sections that require personal information, such as the student's name, age, grade, and contact details. Ensure that these details are accurately filled in.
03
In the academic performance section, provide relevant information regarding the student's grades, test scores, and any additional data that reflects their academic performance accurately.
04
Use the provided space to describe specific areas where the student is facing academic challenges or showing signs of being at risk. Include details about coursework difficulties, attendance issues, or any behavioral concerns that might affect their academic progress.
05
Make sure to provide any additional supporting documentation or evidence, such as previous academic records, teacher observations, or assessments, to support your referral.
06
If there are any recommended interventions or strategies that you believe would benefit the student, clearly articulate them in the appropriate section of the referral form.
07
Double-check all the information you have provided to ensure accuracy and completeness before submitting the form.

Who Needs Referral Form Academically At-Risk?

01
Teachers: They are the primary individuals responsible for identifying students who are academically at-risk and need additional support. Teachers closely monitor student performance and can provide valuable insights through the referral form.
02
School Administrators: Principals, counselors, and other administrators also need referral forms academically at-risk to gather data and identify students in need of intervention. These forms help them allocate appropriate resources and develop intervention plans.
03
Parents or Guardians: Referral forms academically at-risk are also essential for involving the student's parents or guardians in addressing their academic difficulties. The form provides a means for communication and collaboration between schools and families to support the student's learning journey.
Remember, accurately completing the referral form academically at-risk is crucial in identifying and supporting students who may be facing academic challenges or are at risk of falling behind.
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The referral form academically at-risk is a document used to identify students who are struggling academically and may need additional support or intervention.
Teachers, counselors, or other school staff members are typically required to file the referral form for students who are academically at-risk.
The referral form can usually be filled out electronically or on paper, and typically requires information about the student's academic performance and any interventions that have already been attempted.
The purpose of the referral form is to ensure that students who are struggling academically receive the support and intervention they need to succeed.
Information such as the student's grades, attendance, behavior, and any previous interventions or supports must be reported on the referral form.
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