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Referral to CPSE

Committee on Preschool Special Education Services

Jennifer Ray

CPSE Chairperson

(315) 696-6221

Please click the form listed below to download and save. You will fill this out with the information required for the referral.


Form Coming soon.... (At this time please just submit a letter requesting a CPSE evaluation to the Student Support Services Office. 

Your interest in having your child evaluated to determine eligibility for preschool services starts with our online Pre-Registration process. We recommend that you start the process by contacting the staff at Early Childhood Direction Center (ECDC) for assistance in selecting the evaluator that seems a best fit for your child's needs. The service you select will evaluate your child and make recommendations to our Committee on Preschool Special Education (CPSE).


The Early Childhood Direction Center may be reached at (315) 443-4444 and is located at 200 Huntington Hall, Syracuse, NY 13244-4230

An ECDC staff member will talk with you about

*  What happens during the evaluation process and the meetings of the Committee on Preschool Special Education;

*  The meaning of the Due Process Rights (including the possibility of stopping the entire process at any time);

*  The list of available evaluators in the area to select from;

*  The registration process and referral form;

*  Any questions that you have about your child's needs.


All children in our district must be registered prior to receiving an evaluation or services. Please complete the Online Registration process. In the additional information section, select to complete the CPSE Referral Form. You can attach the Referral Form you downloaded from above for our review. Please keep a copy for yourself.


Access online registration process by clicking the following link (LINK COMING SOON): Online Registration Link (main school web page has link)


You will need to call to set up an appointment to provide a copy of your child's birth certificate and proof of residency. These documents must be on file with the Tully  CSD Student Support Services Department before the process can commence for referring your child for services. The CPSE secretary can be reached at (315) 696-6221 to set up a time to provide these documents.


Once all documentation has been received and reviewed for your child, the Student Support Services office will determine the specific types(s) of evaluation that should be completed and request by mail your consent to conduct the evaluation(s) and mail the Due Process Rights for you to review. You can also view the Due Process Rights by clicking the Link on our page. You will also be asked to sign a release of information for the evaluator to contact your pediatrician for medial information required for the evaluation process.


Additional questions can be directed to Jennifer Ray at the phone number listed above.




Tully Central School District
Robert J. Hughes, Superintendent
20 State Street, Tully, NY 13159

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