For Staff Staff Mail Remote Access Server Remote Access Manual Professional/Personal Day Request Form Edline Field Trip Request Form Request for Peer Tutor S.A.C. Referral Foundation Grant Application Mother's Club Grant Request Form Ursuline Academy of Cincinnati S.A.C. Referral Referring Teacher's First Name: Referring Teacher's Last Name: Student's First Name: Student's Last Name: Date of Birth: Grade: Date: A. State the problem(s). Describe the observed behavior(s) that concern you (do not include hearsay or subjective comments): B. Please indicate the interventions you have tried. Spoke to the student privately after class Explained class rules and expectations Explained concerns Gave student help during unscheduled times Changed Student's seat Spoke with parent on telephone Gave student special work Checked cumulative folder Held conference with parent in school Sent home interim progress report Arranged tutoring for student Have given student extra attention Have assigned demerits Have referred student to guidance and/or administration Other: C. What would you like to see happen or change as a result of this referral? D. Are there any other pieces of information that you think would be helpful? Ursuline really helped prepare my daughter for college. By the time they get there, to a certain extent, they've already learned to manage their time. Plus, I love the fact that it's an all-girl school. Janie, Parent Copyright Ursuline Academy 2003 Site design and development by Tellus