‘School Attendance Improvement Plan (SAIP) Name: Date: Goal: increase school attendance. { Name of Student Home Address: Special Needs or Health Concerns: Home Phone Number: Date of Birth: Grade: Gender: Name of School: ‘School Address: Principat’s Name: School Phone Number: Referral’s Name: Name of Parent/Guardian: Parent Home Address: | Parent Work Address: | Parent Home Phone Number: | Parent Work Phone: ‘Written Excuse | Reason(s) for Absence: | Action Takei Provided? (Y/N) (Letters, Phone Calls etc) 1.) See Attached = _ 2) a 3.) 4)List of those who attended the SAIP and Role/Relationship to student: 1) (2) 3) 4) 5) — 6.) ‘Student Strengths: Description of Strength: [ Relevance to the plan: 1) | 2) I 3.) General Information Regarding Family and Habits/Routines: Does the student have siblings, step or half-siblings, or are other children or young adults living in the household? - With whom does the student live during the week? - What type of transportation does the student use to get to school? - Additional information/comments: Assessment of Attendance: [ Description of Probi Responsible Party: Solutions to Put into Place: Description of Solution: Responsible Parti 1) 2) 1 3.) 4) titi)Specific Potential Benefits for Compliance with Plan: a) 2) 3) 4) Specific Potential Consequences for Non-Compliance with Plan: 1) 2) 3) 4)