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Series 604. - 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