• Office Truancy Referral Form 26-27

    Upi Elementary School
  • Office Truancy Referral Form (OTRF) Guidelines
    Teachers are responsible for monitoring unexcused absences, completing the required interventions, and documenting all parent or guardian contact efforts.

    When to Complete an OTRF
    Complete and submit a separate OTRF when a student reaches each of the following attendance milestones:

    3 unexcused absences — complete the 1st Attempt section
    6 unexcused absences — complete the 2nd Attempt section
    9 unexcused absences — complete the 3rd Attempt section
    12 unexcused absences — complete an additional referral form as required

    ***A new and separate OTRF must be completed for each milestone: 3, 6, 9, and 12 unexcused absences.

    Teachers should NOT wait until the student reaches the 3rd, 6th, or 9th absence to begin making contact.

    For example:

    Day 1: Conduct and document an intervention/contact attempt.
    Day 2: Conduct and document another intervention/contact attempt.
    Day 3: Conduct and document an intervention/contact attempt, complete the 1st Attempt section, and submit the OTRF.

    Required Documentation
    Each OTRF must include detailed documentation of all interventions and contact attempts, including:

    Date and time of each attempt
    Name of the parent, guardian, or individual contacted
    Telephone number called
    Method of communication used
    Outcome of the communication
    Additional follow-up actions taken
    All interventions listed in the applicable section of the OTRF must be completed.

    Important Contact Requirements
    Leaving a voicemail or calling a disconnected, out-of-service, or incorrect telephone number does not constitute successful parent or guardian contact.

    If the listed contact information is unsuccessful, teachers must use all available school resources to obtain updated information and continue outreach. This may include:

    Contacting the school nurse or main office to review emergency contact information
    Trying alternate telephone numbers listed in the student’s records
    Requesting assistance from the school’s outreach program
    Requesting a home visit when appropriate
    Document every action and contact attempt on the OTRF.

    Submission and Administrative Action
    Once the appropriate section has been completed- Submit the OTRF to the administrator for review and administrative action.

  • Reporting Date*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Attendance Dates & Total Unexcused

    PD: Professional Development; H: Holiday;

     R: Recess-No Classes;  FMD: Flexible MakeUp Day

    PTC: Parent/Teacher Conference

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  • ATTEMPTS to Address Unexcused Absences

    **Students with three (3) or more unexcused absences should be referred to the administrator in charge of attendance. Submit a referral for each new set of three (3) unexcused absences; to include ALL previous unexcused absences**

  • (1) Student Counseled/Warned Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (1)Date of Letter Sent Home
     / /
    2 digit month, 2 digit day, 4 digit year
  • (1)Outreach Referral Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (1)Parent/Guardian Meeting Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (1) Were you able to establish parent contact?*
  • 0/100
  • (2) Student Counseled/Warned Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (2)Date of Letter Sent Home
     / /
    2 digit month, 2 digit day, 4 digit year
  • (2)Outreach Referral Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (2)Parent/Guardian Meeting Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (2) Were you able to establish parent contact?*
  • 0/300
  • (3) Student Counseled/Warned Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (3)Date of Letter Sent Home
     / /
    2 digit month, 2 digit day, 4 digit year
  • (3)Outreach Referral Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (3)Parent/Guardian Meeting Date
     / /
    2 digit month, 2 digit day, 4 digit year
  • (3) Were you able to establish parent contact?*
  • 0/300
  •  
  • Should be Empty: