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Fostering Learning Program (FLP) - Odysseyware New Student Referral Form

Odysseyware Referrals

Please fill out the below referral form to request registration for a new youth. All fields are required(*). An email with the new youth's account information will follow your submission within 24 hours. Please contact the FLP Program Manager if there are any questions or technical issues at or 773-655-6887.

REFERRED STUDENT INFORMATION

Center or Agency (Odysseyware Campus)

Student First Name

Student Last Name

Odysseyware Username

Odysseyware Password

DCFS Youth? Yes No

DCFS ID

Date Of Birth

Gender Female Male

Race Asian Black Latino White Other

Current Grade Level Elementary 6th 7th 8th 9th 10th 11th 12th GED Vocational College

Special Education (SPED) Status Yes No Unknown

Individual Education Plan (IEP) Status Yes No Unknown

Pregnant/Parenting Teen (PPT) Status Yes No Unknown

REFERRING ADULT CONTACT INFORMATION

Your First Name

Your Last Name

Your Phone

Your Email

Please enter word displayed in image.

Thank you for your Odysseyware Student Referral Submission. Please allow up to 24 hours for this account to be active on our Odysseyware Site.

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