Wyandotte Public Schools

THE LINCOLN CENTER


New Student Referral Packet

  PLEASE ALLOW 2-3 WEEKS TO COMPLETE THE REFERRAL PROCESS











Date of referral______________   Desired start date____________________

Student’s name______________________________ D.O.B._____________

Referring District_____________________School_____________________

Student’s certification (ASD, MOCI, DD) ______________________

Parent/Guardian_____________________________ Phone______________

Address___________________________________ City________________

Zip_____________ Native language of student________________________

Name of person initiating the referral________________________________

Phone__________________________ E-mail_________________________

Is this student making a lateral transfer from a center based program? ______

Wyandotte Public Schools

THE LINCOLN CENTER
New Student Referral Packet