CAIU Nonpublic Student Consultation Request
Only nonpublic school administrator or nonpublic school staff can complete this form
Name of person completing request
First Name
Last Name
Email of person completing request
*
example@example.com
Student Name
*
First Name
Last Name
Student Grade
*
Please Select
K
1
2
3
4
5
6
7
8
9
10
11
12
Nonpublic School
*
Please Select
Al-Huda School
Al-Sabereen School
Arche Classical Academy
Bishop McDevitt High School
Carlisle Christian Academy
Christian School Grace Baptist
Covenant Christian Academy
Harrisburg Academy
Harrisburg Adventist School
Harrisburg Catholic Elementary
Harrisburg Christian School
Heritage Christian Academy
Hershey Christian Academy
Holy Name Of Jesus School
Joshua Learning Center
Logos Academy Harrisburg
Londonderry School
Nativity School of Harrisburg
Northern Dauphin Christian School
Sequoia Christian School
Seven Sorrows Bvm School
Silver Academy
St. Catherine Laboure School
St. Joan Of Arc School
St. Joseph School
St. Margaret Mary School
St. Patrick School
St. Stephens Episcopal School
St. Theresa School
The King's Table Schoolhouse
The Samuel School
The Worship Academy School of the Arts
Trinity High School
Upward Christian Academy
West Shore Christian Academy
Request
*
Review available data to provide suggestions to school staff and/or parents
Attend parent meeting
Conduct student observation for academic concerns
Conduct student observation for behavioral concerns
Other
Reason for Request: Please describe the specific behaviors or areas of concern.
*
Submit
Should be Empty: