About this Form
Form number: 336-55
Audience: School Staff
Last revised: October 2014
School staff will use this checklist as a guide in preparing the packet. The PPW from the referring school will review the packet using this checklist. It is important that referral packets for alternative programs are submitted complete with all required documents. Completed packets will provide accurate information to assess student needs for making appropriate placement recommendations and for developing academic and/or behavior goals.
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