Policy - IHBAJ-E

POLICY: IHBAJ-E

EFFECTIVE DATE: 3/1/00

CANCELS SHEET DATED: NEW

REVIEWED BY POLICY COMMITTEE: 9/23/03

PROGRESS REPORT FORM

Date: ___________________________________ High School:______________________________

Student’s Town Responsible

Name: __________________________________ for Student: _______________________________

Address: ________________________________ Send to Attention of:______________________________

Fill Out Relevant Portion

A. January Progress _____ June Progress ______

_____ No concerns at this point

_____ The following concerns (academic/special) exist:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Please attach a copy of this semester’s rank card.

B. Concerns with the student:

_____ Transferred to another high school. Date: __________________________________

_____ Moved to another town. Date: __________________________________

_____ Has been absent for more than 10 school days.

Dates of absence: ________________________________________________________________

_____ Has been removed for disciplinary reasons. Date: __________________________________

_____ Referred to an alternative program.

_____ Referred to Student Assistance Team.

_____ Has been referred by staff or parent/guardian for consideration as a possible special needs student.

_____ Other

Summary of action to be taken in response to concerns:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________