St. Lucie County Schools
OCR Data Collection
Students Dismissed from EMH
Student: ___________________ ID#: _______________ Grade: ________ DOB: _____________
Date of Dismissal: ______________________
What supports have been in place for the student during _____________ school year:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Rate the over-all performance of the student for the year (circle one):
Average to above
Below average
Failing
If the student is failing, provide details regarding the reason for the lack of progress:
______________________________________________________________________________
______________________________________________________________________________
Document conferences that have been held with the student and/or parent to discuss student
progress for the school year.
Meeting date
_____________
Topics Discussed
_________________________
Persons in Attendance
________________________
________________________
STS0115 Rev. 02/10