Truancy Intervention Panel Notes Form 2015-2016 Areas 1 & 2

Truancy Intervention Panel Notes Form 2015-2016 Areas 1 & 2
E-mail of person completing form:
Date of TIP:

MonthDayYear
Student ID#:
Student's Full Name:

First NameLast Name
Date of Birth (DOB):

MonthDayYear
Age:
Gender:
Race/Ethnicity:
School:
Grade:
Total Number of Absences:
Total Number of Unexcused Absences:
Total Number of Excused Absences:
Total Number of Tardies:
When concerns occured:
Presenting Issues:
Type of Contact:
School Attendees:
If "other" was checked in last question please explain:
Student/Family Present for TIP:
Comments/Notes:
Panel Recommendations:
If "other" was chosen for the above question please explain:
Attendance Policy & Law:
Should be Empty: