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602.6.1.2P - Referral Team Summary for Grade Acceleration

602.6.1.2P - Referral Team Summary for Grade Acceleration

Adopted: September 1980
Revised: September 2021

 

Download 602.6.1.2P - Referral Team Summary for Grade Acceleration

 

To be completed by referral team:

 

Student’s name                                                                                                                 

 

Date of birth                          School                                                   Grade                                  

 

Name of parent(s)/guardian(s)                                                                                                                 

 

Address                                                                                       Phone                                                                                                  

 

 

1.  Reason(s) why grade acceleration is being considered.

 

 

 

 

2.  What alternatives/interventions have been tried to meet the student's academic and emotional needs?

 

 

 

 

3.  Standardized test data. (MAP/Standardized Achievement/Cognitive scores or percentiles)

 

 

 

 

4.  Other test data or pertinent information.

 

 

 

 

_________________________________           __________________________________________

            Date of referral meeting

                                                                                                                                                                    

 

                                                                                                                                                                    

 

                                                                                                                                                                    

                                                                             Signature of referral team members

 

Please check one:

   Complete 602.6.1.3P, Permission for Grade Acceleration Consideration

   Complete 602.6.1.4P, Denial of Consideration for Grade Acceleration

 

_______________       _______________

        Date                                          Signature of principal

 

c: case studies file