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2019-2020 Referral Form


  1. 1. Step One
  2. 2. Step Two
  3. 3. Step Three
  4. 4. Step Four
  • Step One

    1. 2019-2020 Truancy Referral Form

      Referral Source

    2. Step 1 Instructions:

      The information provided in this section of the truancy referral is to provide us with the contact information for the person that is submitting the truancy referral.

    3. Please enter your full name

    4. Please enter your job title (i.e. Principal, Assistant Principal, Dean, Social Worker, Teacher, Attendance Clerk)

    5. 555-555-5555

    6. 555-555-5555

    7. Please enter your email address, so we may contact you

    8. Secondary Contact Person

      In this section, please let us know if there is someone that you would like us to contact directly for attendance update requests. This section is not required, but is helpful.

    9. 555-555-5555

    10. District and School Information

      Please use the list of Lake County districts and schools. If your school is not on here, please contact Andrea Kowitz at (847) 752-0169 or by email: Please keep in mind that if you are a private placement or therapeutic day school, the truancy referral must come from the home district. The only exceptions to this rule are SEDOL and NSSED, as they are considered to be public school districts providing Special Education services.