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CMS-07-021/023 - Los Angeles County Department of Children and ...

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Name <strong>of</strong> School:<br />

Address <strong>of</strong> School:<br />

<strong>Los</strong> <strong>Angeles</strong> <strong>County</strong> Probation <strong>Department</strong><br />

Placement Quarterly Report<br />

Education<br />

Grade: Attendance: GPA:<br />

Credits<br />

Reading Level: Math Level:<br />

Earned:<br />

Total Credits:<br />

Anticipated High School Graduation (GED)<br />

Date:<br />

Credit check w/ completed credits<br />

& required credits for graduation attached.<br />

Most recent report card attached / or<br />

Most recent grades<br />

are:<br />

Referred to Special<br />

Ed<br />

Vocational Training:<br />

Strengths <strong>and</strong><br />

Weaknesses:<br />

Name <strong>of</strong><br />

Doctor:<br />

Addres<br />

s:<br />

Telephon<br />

e:<br />

Rev. 02/26/2004 Page 2 <strong>of</strong> 7<br />

1 month Prior to 19 th B-Day Yes No<br />

Copy <strong>of</strong> transcripts attached.<br />

IEP: Yes<br />

No Most recent attached Date:<br />

School Behavior Academic Progress<br />

Post High School Plan / Alternative<br />

College Military<br />

Vocational Training Other:<br />

Medical / Physical Information<br />

Name <strong>of</strong><br />

Dentist:<br />

Address:<br />

Telephon<br />

e:

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