BASE Learning
Program - Student Referral Process
TO BE COMPLETED BY DISTRICTS ONLY
Please follow the steps below to submit a Student Referral to
the BASE Learning Program.
1. Call the RSSP main office at 847-872-1900 to discuss the student's placement and confirm
availability.
2. Confirm the student’s family has been notified and accepts the BASE referral for the student.
A copy of the BASE Learning Program Student Orientation Guide can be found on the website.
3. The following information will be required:
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Student’s Emergency Contact Information
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Reason for referral
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Documentation of the referral incident
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Academic Instructional Guide / Materials: Students must bring their school-issued laptop or tablet along with the charger. This device will be used to complete school assignments. If a student does not have a device, please ensure that academic materials are provided and that they have a list of the subjects and tasks they are expected to complete. (Optional)
4. Complete the Student Referral Form. Click the link below to complete the BASE Learning
Program Student Referral form. The "School District Liaison"; and "Student Information"
sections must be completed to "Save & Continue Later". A link to complete the referral will be
emailed to the District Liaison’s email address, which can then be forwarded to other school staff
to complete the referral as needed.
Link to BASE Learning Program Referral Form
5. Submit the Student Referral Form. Once the referral is complete, click the “Submit
Application” button at the bottom of the page. Once submitted, you will be immediately notified
at the top of the page that the referral has been submitted.
6. The district will confirm transportation arrangements for the student.
Please feel free to contact us with any questions/concerns at 847-872-1900. Thank you.