Prevention Intervention Registration Form – Just another DeKalb County Schools site

Same Programs – New Look

GRIP/POINTS consolidated, GRIP will cover both aspects drug & violence related (Grades 6-12).

Dates for GRIP(required)

First Name:(required)

Email Address:(required)

Last Name:(required)

Phone:(required)

Parent's Email Address:(required)

Parent's Phone:(required)

Student Id:(required)

Student's First Name:(required)

Student's Last Name:(required)

Languages Spoken(required)

English

Spanish

Other

Previously Attended?

Student has previoulsy attended and completed this program.

Student's School Name(required)

Student's Middle Initial:

Special Needs?

Student has special needs.

Indicate the language spoken by parents here

In School(required)

Out of School:(required)

Total:(required)

Please state the categories for referral as stated in the Rights and Responsibilities Handbook. Provide a BRIEF description of the offense.

Please state a brief reason(s) for referral IF NOT LISTED in the Rights and Responsibilities Handbook.

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