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GRCNeed To See Form

The document is a referral form for a student to see the Graduation Resource Counselor. It requests information such as the student's name, referring person, reasons for referral, academic performance issues like grades and incomplete assignments, attendance issues, behavioral issues, and any other relevant information or actions already taken to help the student. The form should then be returned to the Graduation Resource Counselor.

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ifac09
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30 views1 page

GRCNeed To See Form

The document is a referral form for a student to see the Graduation Resource Counselor. It requests information such as the student's name, referring person, reasons for referral, academic performance issues like grades and incomplete assignments, attendance issues, behavioral issues, and any other relevant information or actions already taken to help the student. The form should then be returned to the Graduation Resource Counselor.

Uploaded by

ifac09
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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GRADUATION RESOURCE COUNSELOR

NEED TO SEE FORM

School__________________________ Date________________

Student’s Name_____________________________________

Referring Person____________________________________

Reason(s) for referral____________________________________________________________

Please check relevant items:

Academic Performance Classroom Conduct

______ Current grade average_____ _______ Disruptive in class

_______ Incomplete assignments _______ Lack of concentration

_______ Decline in quality of work _______ Inattentive during class

_______ Underachieving

Attendance Behavior

_______ Frequent absences _______ Hyperactive

_______ Often late to class/school ______ Withdrawn

_______ Frequent cutting of class _______ Defiant

_______ Immature

_______ Seeks adult attention

_______ Lethargic

List any additional information and action taken to help this student_____________________________________

___________________________________________________________________________________________

RETURN THIS FORM TO THE GRADUATION RESOURCE COUNSELOR

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