2013-2014 Daim ntawv los xaiv kev pab cuam (SES)

2013-2014 Daim ntawv los xaiv kev pab cuam (SES)

Xa Tuaj Rau:
Twin Rivers Unified School District
Attn: Categorical Programs Office
3222 Winona Way
North Highlands, CA 95660
Nqa ntawm tes tuaj cev rau:
Twin Rivers Unified School District
Categorical Programs Office
5115 Dudley Blvd., Bay A Entrance
McClellan, CA 95652
Thov ua daim application no yog koj nyiam SES thiab xav kom muaj tus neeg pab qhia ntawv rau koj tus menyuam. Cov menyuam yuav tsum kawm
hauv cov tsev kawm ntawv Title I xyoo 2 (los sis tshaj sauv) nyob rau Program Improvement thiab tau su noj dawb/them tus nqi tsawg thiaj li tau txais
cov kev pab no. Yog muaj ntau daim application es thooj nyiaj tsis txaus, cov menyuam uas kawm tsis tau ntawv (xeem tsis tau qhab nees zoo) yuav
yog cov xub tau kev pab ua ntej. Yog xav kom daim application no tuaj txog thov xa los sis nqa tuaj rau qhov chaw nyob no los sis xa rov tuaj rau koj
tus menyuam tus xib fwb.
2013-2014 Daim ntawv los xaiv kev pab cuam (SES)
Ntaub Ntawv Txog Tus Me Nyuam & Nws Tsev Neeg
Cov Tuam Txhab Uas NiamTxiv Xaiv
Niam txiv/Tus siab xyuas Npe: ________________________________________
Saib daim ntawv qhia txog cov tuam txhab uas nej yuav tau xaiv. Nej yuav tsum
xaiv 3 lub. Twin Rivers Koog Tsev Kawm Ntawv yuav qhia tsis tau hais tias koj
yuav tsum xaiv lub tuam txhab twg. Tsis pub cov tuam txhab (SES providers) ua
koog no kom tiav!
oNiam
oLwm tus__________________________
Lub thib 1 : __________________________________________________
Tsev kawm ntawv npe: ___________________________ Qib: _______________
Lub thib 2: __________________________________________________
Xov tooj hauv tsev #: _______________________________________________
Lub thib 3: __________________________________________________
• Kuv nkag siab tias lub tuam txhab thib 1 yog lub kuv xav tau; tab sis, yog lub tuam txhab no
tsis muaj qhia nyob rau cheeb tsam ntawm kuv koog tsev kawm ntawv. Yog kuv tsis tau lub
thib 1 ces kuv tus me nyuam yuav tau txais lub thib 2 los sis lub thib 3.
• Kuv nkag siab tias kuv yuav tau coj kuv tus me nyuam mus cuag tus neeg qhia ntawv hauv
SES thiab mus tos nws rov los, thiab tej zaum nws yuav qhia los sis yuav tsis qhia nyob rau
hauv kuv tus me nyuam lub tsev kawm ntawv.
•Kuv nkag siab tias koog tsev kawm ntawv yuav pom zoo nrog lub tuam txhab, thiab tus neeg
qhia ntawv mam li hais qhia rau kuv seb yuav sib ntsib rau lub caij twg los teeb hom phiaj rau
kuv tus me nyuam kawm.
• Kuv nkag siab tias qhov kuv kos npe no kuv tso cai rau lawv muab kuv tus me nyuam cov
ntaub ntawv tso tawm, xws li daim IEP los sis daim 504 Plan, thiab cov ntawv xeem hauv
xeev, mus rau tus neeg qhia ntawv los pab qhia kuv tus me nyuam. Cov ntaub ntawv no
tsuas yog siv rau txoj kev kawm xwb. Kuv nkag siab tias tus neeg qhia nws tau cog lus yuav
zais kuv tus me nyuam cov ntaub ntawv tsis pub qhia rau lwm tus.
Menyuam Npe: ____________________________________________________
oTxiv
Tus saib xyuas
Xov tooj hauj lwm los ntawm cev #: ___________________________________
Chaw nyob: _____________________________________________________
Zos: _____________________________ Zipcode: ____________________
Email: ___________________________________________________________
Xav tau niam txiv ntaub ntawv ntxiv
Koj tus menyuam puas muaj daim ntawv application noj su
dawb/them tus nqi tsawg nyob rau hauv nws cov ntaub ntawv
khaws tseg cia?
Koj tus menyuam puas tau kawm ntawv Special Education
thiab txais kev pab?
Koj tus menyuam puas yog ib tug English Language Learner
(ELL)?
otau
otsis tau
otau
otsis tau
otau
otsis tau
Naim Txiv/Tus saib xyuas xees npe ________________________ Hnub: __________
FOR OFFICIAL USE ONLY: Is student eligible for free/reduced-price lunch? Y / N
TRUSD Official Signature ____________________________ Date: _____________
Xa daim ntawv no tuaj TSIS PUB DHAU lub 10 hlis tim 31, 2013