Student Referral Form

(This form must be completed by student’s teacher)

The Children’s Literacy Center, a private non-profit community organization provides individual assistance to students who are reading below grade level, second semester 1st grade through 6th grade reading level (middle school and high school students welcome).

Enrollment is available at no cost to families.

In order for us to best serve the needs of our students, we ask that each meet the guidelines listed on this student referral form.

Fill out one form for each student who qualifies and return to our office.

To qualify, students must be:

  • At least a second semester first grade reader.
  • A student reading below their appropriate grade level.
  • Not struggling with Dyslexia.
  • Not currently enrolled in an IEP or any special education.
  • Demonstrating age appropriate behavior conducive to a volunteer environment.