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Rydell CITY SCHOOLS
STUDENT/SOCIAL SERVICES OFFICE
STUDENT CONFERENCE FORM
Name of Student ____________________________________________
Age _____________
Grade _____________
Name of Teacher ____________________________________________
School _______________________________
Date of Conference _______________________________
Parent's Name _________________________________
Concerns ____________________________________________________________________________________________
______________________________________________________________________________________________________
Persons Attending Conference
01. ______________________________________________
06. ______________________________________________
02. ______________________________________________
07. ______________________________________________
03. ______________________________________________
08. ______________________________________________
04. ______________________________________________
08. ______________________________________________
05. ______________________________________________
10. ______________________________________________
Recommendation(s) / Results _______________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
_________________________________________________
Date
____________________________________________________
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