Austin Independent School District Truancy Filing Procedures

School Request Services Form

Date: ______

Name of Student: ______Name of Parent: ______

School: ______Cause Number: ______

Recommendations made by: ______

Interventions Completed by School:

(please check all that apply and write date it was completed)

q  Phone call to Parent _____

q  Parent Conference _____

q  Home Visit _____

q  Warning Letter _____

q  Classroom Modifications _____

q  Tutoring _____

q  Guidance/Counseling _____

q  Mentoring _____

q  Referral to LST _____

q  Peer Mediation _____

q  ARD _____

q  Support Groups (please list by name and dates attended______, ______, ______, ______

Recommendations Requested:

(please check all that apply and indicate when it will be available)

q  Tutoring _____

q  Guidance/Counseling _____

q  Mentoring _____

q  Peer Mediation _____

q  Support Groups (please list by name and dates available) ______, ______, ______, ______

q  Other (please list by name and dates available) ______, ______, ______, ______

q  Parenting Classes- contact AISD Family Resource Center at 414-3189

Student/Parent Information/Involvement (please list any special issues or concerns):