Referral for Support

College Steps: Referral for Support
Referral Contact*
Name*

First NameLast Name
Email*
example@example.com
Phone*
Please enter a valid phone number.
Support Team Contacts
Program Location*
REFERRAL SOURCE INFORMATION
Staff Name*

First NameLast Name
Staff Email*
example@example.com
Staff Phone*
Please enter a valid phone number.
Organization*
Staff Role*
Funding*

ApprovedIn Process/PendingPost-District ReferralOther
SUPPORT REQUESTS/RECOMMENDATIONS
College Steps support services include a variety of one-on-one and group supports focused on our four areas of support academic enrichment, social integration, independent living skills, and pre-employment.

Below, please indicate the areas you feel may be beneficial to the student you are recommending for support.

If you have any questions, please schedule an appointment with our Admissions team here or reach us via email.
Path & Planning
Scheduled weekly for each supported student as one-on-one time with the Program Coordinator to review ICP goals and plan for the upcoming week of mentor support, etc.
Community

Choose recommended session(s) as applicable
Peer Group(s) You Recommend:

Anxiety & Stress ManagementBudgeting & FinancePre-EmploymentSocial Thinking & CommunicationTime Management & Organization
Academic Support
Students are scheduled for sessions before/after a class or during the week to recieve mentor support on class preparation, assignments, note reviews, planning upcoming assignments, accessing professor materials, requesting additional tutoring support; etc.

YesNo
In-class Mentor Support
A mentor may be assigned to a course (pending approval from College Steps and the professor) to model note taking and support in engaging in group discussions, class participation, communication with the professor, organization, recording due dates, etc. *Goal is to fade out support over time.

YesNo
Cross Campus Virtual Peer Groups
Students work in group sessions with mentors and other students from across our network. Sessions are held through Google Meet. Mentors use pre-planned curriculum to implement activities with students in all 4 core areas of programming.

YesNo
Cross Campus Virtual Occupational Therapy Sessions

Choose recommended session(s) as applicable
Students may work with Occupation Therapy Interns in online sessions on the following skills:

Anxiety & Stress ManagementBudgeting & FinancePre-EmploymentSocial Thinking & CommunicationTime Management & Organization
Should be Empty:

College Steps: Referral for Support

REFERRAL SOURCE INFORMATION

SUPPORT REQUESTS/RECOMMENDATIONS

Path & Planning

Community

Academic Support

In-class Mentor Support

Cross Campus Virtual Peer Groups

Cross Campus Virtual Occupational Therapy Sessions