Reading referral form

MNOHS faculty and staff:

Please fill out the form below to let me know about a student who shows need for reading intervention / academic support.

A struggling reader may show:

You can also contact me directly if you prefer.

Julie Lindholm

Email: j.lindholm@mail.mnohs.org
Work Cell: (651) 696-0867
School voicemail: 1-800-764-8166 ext. 130

Student name(Required)

First Last

Reason for referral(Required)

Name of referring teacher/staff(Required)

First Last

Referring person's email(Required)

Referring person's phone number(Required)