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Series 602.5.4P - Meeting Summary for Consideration of Retention 

 

Student's name _____________________________________  Date ____________________

Grade ___________  School ____________________________________________________

Summary:

 

 

Signatures of people in attendance:

                                                                                       ,                                    

                                                                                       ,                                    

                                                                                       ,                                    

                                                                                       ,                                    

                                                                                       ,                                    

                                                                                       ,                                    

Signatures of Preassessment Team Members                         Title

The team decision process has been completed in accordance with Administrative Regulation 602.5AR, Retention of Students in Kindergarten through Grade Eight. The above-named student is:

          _____  not approved for retention.

          _____  approved for retention in grade _____.

_______________________________________          ___________

        Signature of Principal                                 Date

Parent or Guardian:  Please sign below to indicate that you are aware of the decision that has been made.

_______________________________________          ___________

      Signature of Parent or Guardian                    Date

•   Copy student's cumulative folder 

•   Copy director of elementary or secondary education

•   If approved, copy to Student Information Supervisor

Procedure/602.5.4P/10-16-06