604.4.1.3.4P - Staffing Summary for Middle School Student Participation in High School Junior Varsity or Varsity Athletic Activities-Gifted Athlete

Adopted: November 1986
Revised: January 2013

Download 604.4.1.3.4P - Staffing Summary for Middle School Student Participation in High School Junior Varsity or Varsity Athletic Activities-Gifted Athlete

Student                                                           Student #                     Date   

School                                                             Grade                                    

A.     Summary of Teacher Comments

        1.  Academic:

        2.  Behavior (in class):

        3.  Social (relationship to peers):

B.    Special concerns expressed by teachers and psychologist, which may interfere with this student’s movement to the junior varsity or varsity level of competition.  (If none, answer none.)

C.    Present at staffing:

                             Title                                                          Name