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SCHOOL APPLICATIONS & FORMS

EXAMPLES OF SCHOOL APPLICATIONS AND FORMS

 

 

 

 

ALE APPLICATION

 

PARKHILL SECONDARY CENTER

ALE

MISSION STATEMENT

 

The mission statement of the Parkhill Secondary Center is to provide each student with the opportunity and guidance needed to acquire the academic and behavioral skills necessary for the pursuit of a productive lifestyle.

 

COMMITTEE MEMBERS:

 

Administration:  Bruce Hill, Bill Huddleston, Jeff Holcombe, Murray Neely, Bryan Blackwood, Brendra Leeper, Lance Pinkerton.

Teachers:  Todd Pinkerton, Tina Braden, Paddy Bell, and Thomas Sweeten.

Judicial Representation:  Robert Mabry

Social Services:  Southwest Mental Health

CCUofA:  Vocational Programs

 

OVERVIEW:

The District has chosen to provide a program designed to meet the needs of two different groups of students that are at risk of failure in the normal public school setting:  students who are at risk of dropping out, students who have a GPA below 2.0 on a 4.0 grading scale, students who lack credits or students who have chronic attendance issues.  We propose to serve these students with a structured educational environment designed to meet their individual needs:

1.  ALTERNATIVE EDUCATION PLAN

2.  AT RISK IDENTIFICATION

3.  INTAKE AND SCREENING

4.  GOALS AND OBJECTIVES

5. DESCRIPTION OF SERVICES

6. SERVICE DELIVERY STRATEGIES

7.  FACILITIES

8.  INDIVIDUALIZED INSTRUCTION

9. CLASS SIZE AND STUDENT/TEACHER RATIO

10. GRADUATION

11. EVALUATION

12. CONTINUATION OF PROGRAM

 

 

 

 

SW COUNSELING & MENTAL HEALTH APPLICATION

 

 

 

 

 

 

 

SOUTHWEST COUNSELING & MENTAL HEALTH CENTER, INC.

 

1312 COLLIN RAYE DR.

P.O. BOX 459

DE QUEEN, AR 71832

 

Mission:

It is the mission of the Southwest Arkansas Counseling and Mental Health Center, Inc. to prevent, treat and cure mental illnesses and related disorders regardless of an individual's ability to pay.

Serving individuals in Hempstead, Howard, Lafayette, Little River, Miller and Sevier Counties (with limited services in Nevada and Pike Counties).

 

For over 40 years, Southwest Arkansas Counseling and Mental Health Center, Inc. (SWACMHC) has been providing services for individuals and families throughout southwestern Arkansas.  Services are provided to individuals with mental health and/or substance abuse problems, as well as youth experiencing legal problems.

 

Select programs are accredited by CARF International.

 

 

 

 

CONTACT US TOLL FREE AT
1-800-652-9166
 
 
 
Click to Replace
 

IMMEDIATE POSITION VACANCIES - SEE EMPLOYMENT PAGE

Our current services include the following:

 

 

  • Assessment and Referral
  • Outpatient Adult, Child, Family and Marital Therapies
  • Psychological Evaluation
  • Psychiatric Assessment and Medication Management
  • Day Treatment and Community Integration
  • Therapeutic Foster Care
  • School-based Services
  • Youth Services
  • Emergency Services
  • Substance Abuse Services
  • Drug and Alcohol Safety Education Program
  • Consultation and Education

 

YOUTH SERVICES LOCATIONS

 

            MILLER COUNTY

[Formerly] IRON MOUNTAIN NEIGHBORHOOD CENTER

601 Hazel St.; Texarkana, AR 71854   (870) 772-1371

 

MILLER COUNTY YOUTH SERVICES

601 Hazel St.; Texarkana, AR 71854   (870) 774-4485

 

            HEMPSTEAD COUNTY

300 East 20th St., P.O. Box 452; Hope, AR 71801   (870) 777-5858

 

            HOWARD COUNTY

421 North Main St.; Nashville, AR 71845   (870) 845-7527

 

            LAFAYETTE COUNTY

#27 Courthouse Square; Lewisville, AR  71845   (870) 921-5482

 

            LITTLE RIVER COUNTY

Little River County Courthouse Annex; Ashdown, AR 71822   (870) 898-5528

 

            NEVADA COUNTY

204 East Pine St.; Prescott, AR 71857   (870) 887-5375

 

            PIKE COUNTY

10 North Kelly, P.O. Box 909; Murfreesboro, AR 71859   (870) 285-2316

 

            SEVIER COUNTY

183 Hwy. 399; DeQueen, AR 71832   (870) 584-3592

Programs and Clinics - page 1

OUTPATIENT MENTAL HEALTH AND SUBSTANCE ABUSE CLINIC LOCATIONS:  Monday - Friday   8:00 a.m. - 5:00 p.m.

 

24 HOUR EMERGENCY SERVICE TOLL FREE 1-800-652-9166

TEXARKANA CLINIC & ADMINISTRATIVE OFFICES

2904 Arkansas Blvd.; Texarkana, AR 71854

(870) 773-4655

Evening Clinic: Mon. & Thurs. 5:00 - 7:00 p.m.

 

CHILDREN/ADOLESCENT THERAPEUTIC FOSTER CARE

(870) 774-9396

 

CHILDREN & ADOLESCENT SERVICE SYSTEM PROGRAM (CASSP)

(870) 774-9396

 

DEQUEEN CLINIC

1312 W. Collin Raye Drive, P.O. Box 459; DeQueen, AR 71832  (870) 584-7115

 

HOPE CLINIC

300 East 20th St., P.O. Box 452; Hope, AR 71801  (870) 777-9051

 

NASHVILLE CLINIC

508 N. Second St., P.O. Box 576; Nashville, AR  71852  (870) 845-3110

 

SUBSTANCE ABUSE RESIDENTIAL TREATMENT

 

RIVER RIDGE TREATMENT CENTER

7000 North State Line; Texarkana, AR 71854   (870) 774-1315

 

 

TELEMEDICINE SERVICES NOW OFFERED

Telemedicine Services are now being offered in our Hope and Texarkana, AR locations.  Telemedicine is the use of medical information exchanged from one site to another by the use of video conferencing equipment to improve a patient's clinical health status.  The patient is generally at one location and the physician at another. 

For more inforamation, please contact our offices.

Services

 

The Center offers a variety of outpatient services including individual counseling, family counseling, marital counseling, counseling for substance abuse problems, alcohol safety education services, group therapy, consultation with other health care providers or educational/vocational facilities, psychological evaluation, psychiatric evaluation, medication management, and crisis intervention (telephone and walk-in).

 

To request an appointment, please call one of our offices listed under the Programs and Clinics tab or dial 1-800-652-9166.

 

The goal of the Youth Services  Program is to reduce juvenile delinquency.  To accomplish this goal, the Youth Services Program serves delinquent and high-risk youth that reside in an 8-county catchment area of Southwest Arkansas.  One or more full-time Case Managers serve each county.  Most youth served by the Program are Juvenile Court referrals, but referrals may come from any source.  For more information, send your request to wlovell@swacmhc.com.

 

The goal of the Psychosocial Rehabilitation (PSR) Program is to assist our clients in functioning within the living, learning and working environments that they choose, while utilizing the least amount of services and supports possible, to address the clients' needs, preferences and goals.

 

Community-Based Rehabilitation (CBR) Services provides assistance in many areas of the clients' lives, to facilitate the development of healthy community living skills, independent living skills, socialization skills, appropriate use of leisure time and vocational development.  CBR services are available in the Texarkana area.  For more information about the PRS or CBR programs, send your request to mbrocato@swacmhc.com.

Services to Residential Clients

 

The Center provides psychosocial rehabilitation services to individuals who are clients of the Split Rail Residential Care Facility in Prescott, Arkansas and Horizons of Hope Residential Care Facility in Hope, Arkansas.  These services include, but are not limited to, case management, community-based rehabilitation and medication management.  Services are holistic in nature, and are designed to develop and facilitate independent living skills.  Anyone interested in more information about Split Rail or Horizons of Hope may request literature by emailing your request to mcluts@swacmhc.com.

 

Substance Abuse Services - The Center provides intensive outpatient and supportive outpatient substance abuse services at the Texarkana and Hope outpatient clinics.  Services can be obtained by calling the telephone numbers listed for those clinics.

 

The Center also provides residential substance abuse treatment services at the River Ridge Treatment Center in Texarkana.  Individuals who desire services may call (870) 774-1315 to schedule a screening.  Aftercare/support services are also available after discharge.

 
 

 

 

EXAMPLE OF APPLICATION FOR ADMISSION TO COSSATOT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Concurrent Enrollment

General Information

CCCUA welcomes all secondary schools in our service area (Sevier, Howard, Little River, and Pike counties) to participate in our Concurrent Enrollment Program (CEP). We currently have Memorandums of Understanding with the following schools: Ashdown, Delight, De Queen, Dierks, Foreman, Horatio, Kirby, Mineral Springs, Murfreesboro, and Nashville. A variety of courses are offered including the following. Please contact Kristin Bowden, ext. 1126, to inquire about other courses available for CEP credit.

 

 

 

 

 

EXAMPLE OF NURSE REFERRAL FORM

 

 

 

 

 

HEALTH SERVICES

DE QUEEN PUBLIC SCHOOLS

 

The role of the school nurse is to assess, evaluate, study, plan, implement and do research.  The major part of the nurse's time is spent in direct childcare, personal conferences, appraisal and follow-up.

 

Health Services include:

1.  Maintaining students health records:

     Imminizations

     Birth Certificate

     Religious Exemptions

     Medical Exemptions

2.  Physical Screenings:

     Height

     Weight

     Scoliosis

     Vision

      Hearing

3.  Referrals to appropriate medical professions for students in need

4.  Seek Community Assistance:

     Dental

     Glasses - Lions, etc.

     County Health Services

5.  Supply information to special services

6.  Provide emergency care, first aid, and nursing services at school site

7.  Be available to do health related units in the classroom

8.  Provide parents with health related information

 

Shelly Pruitt           Direct Treatment & Medical          870-642-4247

                                                                   Fax:          870-642-7454

 

 

 

Contact Sandy Moore

School Phone:
870-642-3077

Sandy Moore

Upcoming Events

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