Follow the steps to successfully complete the referral form.

1. Press the ‘Get Form’ button to access the form and open it in your preferred digital editor.
2. Start by entering the student's last name in the designated field. This should be clearly printed or typed to ensure legibility.
3. Next, fill out the school that the student is currently attending. This information is essential for processing the referral.
4. Input the student’s first name and date of birth in the appropriate fields, ensuring that all information is accurate and matches official records.
5. Provide the school’s telephone number to facilitate communication regarding the referral.
6. Indicate the student's current grade level in the provided space.
7. Enter the FCPS Student ID number or the address of the private school the student is attending, as applicable.
8. List the name of the FCPS Advanced Academic Resource Teacher or middle school counselor, or the private school teacher, in the specified area.
9. Include the name of the FCPS elementary classroom teacher to provide context on the student’s academic environment.
10. Fill out the parents' or guardians' names along with their telephone numbers (home, work, or cell) to ensure reliable contact information is available.
11. Provide the home address, including city, state, and zip code, so notifications regarding the referral can be sent appropriately.
12. Enter an email address to receive updates and important communications about the referral process.
13. Document the language(s) spoken in the home to better understand the student’s background and support needs.
14. In the provided space, clearly explain why you believe the child should be considered for full-time AAP Level IV placement. This explanation is critical for the evaluation process.
15. After all information has been filled out, include the signature of the referral source along with their relationship to the student and the date of the referral.
16. Once you have reviewed all entries for accuracy, save changes to your document, and then download, print, or share the completed form as necessary.

Take the next step towards your child's advanced academic opportunities by completing the form online today.