Middle School Learning Center
Checklist for Referred Students



_____ 1.  Immunization records, TB and physical-- Copies attached.

_____ 2.  Free or reduced lunch forms (if the student qualifies).

_____ 3.  Copy of student schedule.

_____ 4.  Attendance records:
                                        ______  days present
                                        ______  days absent
                                        ______  total enrollment for the year

_____ 5.  Copy of report card to date (if needed) and grades at withdrawl
                  point of nine weeks.

_____ 6.  _________  suspensions so far this year and _____ suspensions
                   in the last year.

_____ 7.  ________ failed classes in the last school year.

_____ 8.  Special Education records, IEP, conference summary or 504
                   plans (only if student qualifies).

_____9.  A copy of the most recent district-wide assessment.
 
 
 
 
 
 

__________________________________________________________________
*All portfolio entries that are finished and instructions or entries that need to be done are to be sent after the student is placed in the Middle School Learning Center.