Series 602.6.1.2P - Referral Team Summary for Grade Acceleration
Adopted: September 1980
Revised: September 2021
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
Procedures/602.6.1.2P/9-30-21