LST Referral Academic Website

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Learning Support Team Referral (ACADEMIC)

Student: Year:
Class: Teacher:
Have the concerns of this referral been discussed with the parents/caregivers?
Would the LST meeting for this student benefit from having the parents/caregivers
present?
REASON FOR REFERRAL
Learning Tick Academic Results Tick
Reading Benchmark
Copying from the board Spelling
Listening Numeracy
Completing tasks Other KLAs
Asking questions Areas of Interest (specify)
Reading aloud
Comprehension
Following instructions
Group work
Participating in discussions
writing
Speaking Learning Support
Staying on task LaST
Retaining information Integration funding
handwriting ESL
Others/s Reading Recovery

Specific details of concern:

Strategies Implemented to date: (eg PLSPs, classroom behaviour plan etc)

Anticipated outcome of this referral:

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