DEWITT, LIVINGSTON & MCLEAN COUNTIES TRUANCY/OUTREACH PROGRAM

 

REPORT OF NON-COMPLIANCE WITH SCHOOL ATTENDANCE LAW

 

Forward after student has been truant from school 10 unexcused days of the previous 180 school days. Complete the information requested and submit:

 

Larry Daghe, DeWitt, Livingston & McLean Counties Truancy/Outreach Coordinator

 

ldaghe@rasblm.org Phone: 309.828.5807 FAX: 309.828.8564

 

Danielle Rork, DeWitt, Livingston and McLean Counties Truancy/Outreach Specialist

 

drork@rasblm.org Phone: 815.575.3189 FAX: 815.842.0920

 

Gail Hinthorn, Office Coordinator Regional Alternative School

 

ghinthorn@rasblm.org Phone: 309.828.5807 FAX: 309.828.8564

 

Attendance: Dates of truancies, both full and 1/2 days, accumalated during the previous 180 school days. Students must be truant 10 unexcused days out of the previous 180 days.

 

Student Name:

 

Person submitting form:

 

School & Address: 

 

Email:

 

 

State month, day, year reporting thru

 

 

August 2009
Total Days Present Truant Absent with Valid Cause
September 2009
 Total Days Present Truant Absent with Valid Cause
October 2009
 Total Days Present Truant Absent with Valid Cause
November 2009
 Total Days Present Truant Absent with Valid Cause
December 2009
Total Days Present Truant Absent with Valid Cause
January 2010
 Total Days Present Truant Absent with Valid Cause
February 2010
 Total Days Present Truant Absent with Valid Cause
March 2010
 Total Days Present Truant Absent with Valid Cause
April 2010
 Total Days Present Truant Absent with Valid Cause
May 2010
 Total Days Present Truant Absent with Valid Cause
June 2010
 Total Days Present Truant Absent with Valid Cause

TOTALS

 Present Truant Absent with Valid Cause

 

 

 

SERVICES USED: DATE OFFERED/SERVICES ACCEPTED OR REFUSED (attach copies of letters, reports, staffing, etc.)

 

Conferences:

 

Principal/Student

 

Counselor/Student

 

Principal/Parent/Student

 

Social Worker/Parent/Student

 

Parent Contact:

 

Phone calls

 

Letters

 

School Services:

 

School Psychologist

 

Administrator/Teacher Staffing

 

Testing/Screening

 

Psychological Testing

 

Program Changes

 

Case Study Evaluation

 

Multidisplinary Staffing Date: 

 

Social Service refferals:

 

Mental Health,DCFS.ETC.

 

Detentions

 

In-School Suspensions

 

Out of School Suspensions

 

Other

 

He/She is not a ward of the court: Yes No

If yes, name of probation officer or case worker and department

 

PLEASE REMEMBER TO ATTACH OR FAX STUDENT ATTENDANCE RECORD AND SCHOOL DISTRICT INTERVENTION DOCUMENTATION TO 309.828.8564.

 

DATE: 

 

Submit: