Office Truancy Referral Form Department of Education 500 Mariner Ave, Barrigada, Guam 96913, 3¥ 2018-2019 ___ TEACHER COMMUNICATION LOG student Name: _Crur., Devin School: Simon Sanchez H.S Grade: _9 Reported by: Yd Flores, Werclier Date:_to/22) 1 Attompts to Address Unexcused Absences "Students with three (3) or more unexcused absences should be refered ¢o the administrator in charge of atlendance, Submita referral for each new set of thee (3) unexcused absences; to Include ALL previous unexcused absences” TWATTEMPT TescheiStatiSchool Personal nfrveiion ‘Comments: Dosoment a ferverians Ua apply (Des & Tinos, Dalal) suden couseat: date: 2th rime: WS | ae wie Spr 1 Shuant aboot abcess and to opt parat nate. or excuse. Sent Lelie Home: Detvered ty: ___Date: _lidlaha, 99 477-8025 off the hneke Sound Parent Contacte esabished: eso telishie lose 911-825. oF the hate Sun Nave Vince Guerrera|Debbic Crz relatonsp:_ Foeens No gyftabus tarnud In with Cndact Be n Checked hutss office ho 10 eres Bi rm Sami riba Meet Sabet ally onty) "hie zo Teacher(Siaf Signature: Date BiH [Pe ATTEMPT TeachariSiailSchool Personal lrvenon: ‘Comments: Document af inengnioss al apply Datos & Times, Detals) ‘Sen Corse: Dae Te a Sen Ler Home: Dat: Deters by. Dat Par Conacedexbishes: ves No ane Fesstors: Teacher Sta Signature? Dates 3 ATTET Tonehor Sahoo! Poranral leven “Comments: Document a wlarverlons tal apy (Dales & Times, Dela) ‘Sule Counsel: Oat: Toe: m Sent eter Home: Dat: Detected by at: avert Conacis ecaenee ver Oo an Restenen: TeaaherStal Signatare Date “AUGUST 2018 “SEPTEMBER 2018 OCTOBER 201 a oe oe 1 3 CD 5s rm 1 Gs @D |n 5 1 Gbap |s won “a 3 Ge |i0 B Is nei |e Bom is 16 nm » xo on [0 2G mcHe 2 [is 20 HED (get 0, 2018 ~ Teche Oneion) ‘DECEMBER 2016 TANUARY IS FEBRUARY OD MARCH TOTS WF WW FM wo TH 3 4 3 6 w |e a ow ® 1 1 i bk B & |e ms wo ulm s 6 7 8 |H 5 6 7 8 7 9 ou |w ge ow 7 wi 2 ob win ep Bow os Rp BBB 22 B mM lik 19 sisc 21 2 |r 19 % 2 2 ge 35 7 Hc 2 MC 2 29 APRILIO HATED, TERE, Mt Fa TH ho203 4 5 1 2 3 8 5 i no lo 7 & 98 io |summer “otal Days Uncxeused BoB Bp BoB [bi is we 17 PD 23 24 25% mu 2 B ou VACATION Is 2 30 HPD PD NC OBSchool: SIMON A. SANCHEZ HIGHLnool Year: 2018-2019 SPED(Part B); ____ SPED[Part C): 804; Si; Guam Department of Education ESCL: Student Parent Community Engagement ‘Support Service & Outreach Team REFERRAL, ESL: {Check one Program for Interpreter/Translator Requests) siren \ o> ae Student’s Name: Cruz Devin NM. Grade: 4_ DoB/Age: P/soloa) Is Tas, TRS, co Home Address: __ 200 Chalan Poipai_Mataguak_Yigo, u%6979 ‘Mother/Guardian: Father/Guardian: Debile Chur Vince Quercem Home: Home: T1-go25, 971-8075, ‘Work: Work: Cell: Cell: DESCRIPTION OF PROBLEM: Excessive unesCused absences STEPS TAKEN BY REFERRING PARTY TO ADDRESS PROBLEM: “sna iped Gaba tuned in > Called Contact $s In_ponercchoo!, no Success ™ St 2 Cheoked nurse's office ntact Info. en © Infirmed assistant princioal, MrSan Nicolas of absences (Vertaity SERVICES BEING REQUESTED: *\nform parents Dew “Turn in emergency Gintact Inf- tp Hoe hurers offic excessive unexcused Absences e (rent dochor’s n Teacher Tile Wendt Fires ‘ame of Referring Pary (PRINT) “ETHNICITY: spe: Est: Assigned Intereatr Date assigned “This information is only being collected for statistical purposes and Revised 02/14/18 dab —wifions@gdoe neh [esa-2319 mall / Contact # DO NOT WRITE BELOW THIS LINE. FOR SSOT USE ONLY Date Received sOTHER PROGRAMS: Ue contact otto diseriminate on the basis of race or national origin,Office Truancy Referral Form Department of Education arrigada, Guam 36913 ‘SY 2018-2018 ~|__ TEACHER COMMUNICATION LOG Student Name: Odetle Syo2i taro ‘School: Simon Sancher High Schoo! Grade: _ 4th Reported by: _ Wendie, Flores Date: _10/30)16 Attempts to Address Unexcused Absences “Students with three (3) oF mare unexcused abzonces should be referred tothe administrator in charge of aifendance. ‘Submita referral for aach new set of three (9) unexcused aeences; to Include ALL previous unexcused absences" ifemenq erent rai met ~ pate Ded ve said his se Cmte Ot —— 7 or dees not Want tp liskn. He Keeps laugh ‘nord tp liskn. ‘ane bn bet ‘tg her fe go te School. He tid her | She Will go g DYA if She Keeps dtieg Parent Conlacted eslabished: Jes No What shes doing, Nome: Syo2itaro oltonship 5 TeachodStall Signature: Date:0 [3a | er ATTENPY Toscheriamehool Parton Intron: aa v ‘Student Counseled: Date: Tine: on Sent Letir Home: Dae Delivered by: ete: rent Contected estabishee: Elves. CN ane: Relator Teacher Sia Signatures Data ears f TSE inca aeTe al i ROOTORERR TT r MW wom Fi Tr ar TW THF 3 1H mu iwiw i ie as 6 7 |t © o Si ia 5 mp 7 8 9 mon 2 3 24 | nN 2 Bo lis 16 17 HOB MoS 6 noe poe on | oo wu |B gD Me & |b bn oH mo m4 25 SE 2 % 7 B® B® 30 ‘Aust 1, 2018 — Teacher Orietatin) [po DB CHM RR OIE S| WANUARY AO SFEBRUARY.ZO09 | SE MARCH OI an a MT WT FM TT TW TAF 3 405 6 BB OB OB OB 1 wou 2 18 4 |p mm 9 w |p 5s 6 7 Hos 6 7 8 7 1 9 2 Hore is 7 wii 2 8 ow i] mB ms BB BB B a2 3 m 3/18 19 sHsc 21 2 (PD 19 2 a 2 2» 30 31 26 2 aE Laan TUNE Tw om Fe TH 1 2 3 4 5 10203 s 9 9 on 2 [6 7 8 9 0 |suMMER BoB Bo B BR lbw is 6 7 m2 4 2 % |o2u 2 3 m4 VACATION 29 430 HPD PD NC OB