Steelton-HighspireSchool District

PO Box 7645

Swatara StreetReynders Avenue

Steelton, PA 17113

Telephone (717) 704-3801

FAX (717) 704-3808

Dr. Audrey L. Utley

Superintendent of Schools

Dr. Wendy A. Quinn Sherry Roland-Washington

Assistant to the Superintendent Assistant to the Superintendent

SES Tutoring Services

Dear Parents:

The Supplemental Educational Services (SES) tutoring is part of the No Child Left Behind Law and provides tutoring through an approved provider for eligible students in at Steelton-Highspire Elementary and Steelton-Highspire Jr./Sr. High School. Eligible students are defined as those who receive free and reduced lunch and or achieved below basic or basic on the 2010 - 2011 PSSA.

If your child is eligible for these services, please complete the enclosed application and return it to Steelton-Highspire School District, c/o Ms. Cynthia Tyler; 250 Reynders Ave. Steelton, Pa 17113 or email her at . If you have any questions, please contactMs. Cynthia Tyler at 717.704.3800 ext. 3803.The enrollment period for the fall ends on October 29, 2012. A second enrollment period is available January 13, 2013. I want to encourage all parents of eligible students to attend and to get free academic help for their children. Thank you for your time and consideration.

Regards,

Mrs. Sherry Roland-Washington,

Assistant to the Superintendent &

SHSD’s Federal Grants Coordinator

REFERRAL for Supplemental Educational Services

Student Referred: Name______

Date of Referral ______Date of Birth ______Grade _____

Reason for Referral: (Include performance data such as test scores and identification of skill or knowledge gaps.)

Contact Information for Source of Referral:

Name______

Relationship to the student [parent, teacher, other (indicate)]:______

Below you will find a list and phone numbers of all available providers for the Steelton-Highspire School District:

------

Parent/Guardian: Please complete the section below and return the entire form to school.

I understand that my child may be eligible to participate in free supplemental services. Based on this information, I have selected the following option:

I decline supplemental services for my child.

I wish to enroll my child in the services offered by the following provider from the providers

listed. Please select your provider below.

SES Provider’s Name / SES Provider Phone
Attain Learning Centers / (717) 730-7070
Sylvan Learning of Harrisburg / (717) 652-0646

I will require assistance from the school to help me make a choice. Please contact me at the phone number and/or email address listed below.

Signature of Parent/Guardian:______

Address: ______City: ______State: ____ Zip: ______

Telephone: ______Email:______

FOR OFFICE USE ONLY:
Student ID# / Enrollment Period / Processed By:

SUPPLEMENTAL EDUCATIONAL SERVICES

PROVIDER SELECTION FORM

Student’s Name (Printed)

Steelton-Highspire Jr./Sr. High School ______2011-2012

SchoolGrade Academic Year

Check the Box that Applies:

My son/daughter WILL participate in the Supplemental Educational Services program as it is described in No Child Left Behind.

  • I am selecting the state-approved provider from the list provided to me.

I select:

Choice One: ______

Choice Two: ______

Choice Three: ______

  • I understand that the district will enter into an agreement with the provider, and I will be notified of a time to meet with the provider to set goals for my student.
  • I understand that the provider will regularly inform me and the student’s teacher(s) of the student’s progress.
  • I understand that if funds are insufficient to cover the supplemental educational services for all of the students who choose to participate, participation will be prioritized on the basis of academic need as defined by the district.

My son/daughter WILL NOT participate this academic year in the Supplemental Educational Services program as it is described in No Child Left Behind.

______

(Signature of parent/guardian) (Date)

______

(Printed name of parent/guardian) (Daytime Telephone number)

______

(Evening Telephone number) (Cell phone number)