ENGAGE New Mexico offers additional support to New Mexico high school seniors. We specialize in providing extra support to help students graduate on time through coaching, mentorship, and additional academic resources.
Student Name
State ID
Name of Person Submitting
Email of Person Submitting
District
Campus Name
Reason for Referral- select all applicable options
Attendance
Online Tutoring
Credit Recovery
At Risk of Not Graduating On Time
Please share more about this student with us:
New student referral — Not yet receiving support from ENGAGE
Already receiving support from ENGAGE — Need to add Credit Recovery
Enrollment Details
District ID
Guardian Name
Guardian Phone
Guardian Email
Address
Additional Phone Number (If applicable)
Date of Birth
Gender
Martinez-Yazzie Act Status — select all that apply
Native American
Economically Disadvantaged
Student With Disability
English Language Learner
Credit Recovery Details
Note: Not all Districts offer credit recovery. If you are uncertain if your district has approved credit recovery, please reach out to our team!
Names of classes being requested
Do these classes meet your district’s qualifications for credit recovery?
Yes
No
This student cannot be dual enrolled. Is this student currently taking any of these classes on campus or with another credit recovery program?
Yes
No
Additional notes or information