District Student Referrals - Spectrum Schools

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District Information

Referring District(Required)

District Contact Name (First & Last)(Required)

District Contact Email(Required)

District Contact Phone

Desired Spectrum School Location

Click Here to see a map of all California Spectrum School locations.

Spectrum Campus(Required)

Student Information

Information submitted below is only accessible to Spectrum Schools and will be used to evaluate whether not we can provide an appropriate placement for your student. All students and families are offered the ability to tour our campus and potential classrooms while availability and appropriateness of placement is being determined.

Student First Name(Required)

Student Last Name

Student Date of Birth

Student Current Grade Level(Required)

Student Home City

Zip Code

Parent/Guardian Name (First & Last)

Parent/Guardian Email

Parent/Guardian Phone Number

Primary Language Spoken at Home

Student Support Information

Tell us a little about the qualifying conditions and other information to help determine the student’s best appropriate placement.

Primary Qualifying Condition(Required)

Secondary Qualifying Condition

Services Needed(Required)

Would you please briefly describe the student’s current placement?(Required)

Any other information that would be helpful in determining appropriate placement of the student?

Please Note

By clicking submit below you acknowledge the information above is accurate to the best of your knowledge. Our team will reach out to schedule time to meet with the student’s family at one of our campuses as well as collect other student related documentation. All families are offered the ability to visit and tour our school while appropriate placement is being determined.

Student Referral Webform