LEIS Outcomes Entry Form

Please verify that the data in all fields is correct before clicking on the Send Data button.

For the fields where several options may be chosen, keep pressed the Control (Ctrl) key while clicking on the options. To clear your choices, simply click on --None selected -- without pressing the Control (Ctrl) key.

Student number:

3. Educational achievements:
(Check all applicable)
8. Economic achievements:
(Check all applicable)
9. Societal achievements:
(Check all applicable)
3. Services provided:
(Check all applicable)
7. Programs/agencies referred to:
(Check all applicable)
14. Follow-up/Reasons for separation:
(Check one)
Reasons for separation before completing level or goal:
(Check all applicable)