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Atascadero USD |  E  6174  Instruction

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PARENTAL EXCEPTION WAIVER

EDUCATION CODE 311(a): Children who know English

Name:__________________________________________ Grade:____________________

School:_________________________________________ Date of Birth:______________

Language Designation:_______________________________________

My child possesses good English language skills and for that reason I request a waiver of the school's Structured/Sheltered English language program. I understand that the objective for my child is to be taught English as rapidly and effectively as possible.

I have personally visited the school to apply for this waiver.

I have been provided a full written description of: the intent and content of the structured English immersion program; any alternative courses of study offered by the District and made available to my child; all educational opportunities offered by the District and made available to my child; and the educational materials to be used in the different educational program choices.

I understand that I must request that this waiver be reconsidered annually, each school year.

Parent/Guardian Signature: _____________________________ Date:______________

Address:______________________________________________________

City:__________________________ State:__________________ Zip:______________

Phone Number:___________________________

For School Use Only:

Child's English standardized test scores: Scores must be at or above the state average for the child's grade level or above the 5th grade average:

Waiver Granted/Denied:___________________ Date:_________________

Signature: ________________________

Exhibit ATASCADERO UNIFIED SCHOOL DISTRICT

version: March 7, 2000 Atascadero, California

Instruction E(2) 6174

PARENTAL EXCEPTION WAIVER

EDUCATION CODE 311(b): Children age 10 or older

Name:__________________________________________ Grade:____________________

School:_________________________________________ Date of Birth:______________

Language Designation:_______________________________________

My child is 10 years of age or older and I believe that an alternate course of study is better suited to my child's rapid acquisition of English. For that reason, I request a waiver of the school's Structured/Sheltered English language program. I understand that the objective for my child is to be taught English as rapidly and effectively as possible.

I have personally visited the school to apply for this waiver.

I have been provided a full written description of: the intent and content of the structured English immersion program; any alternative courses of study offered by the District and made available to my child; all educational opportunities offered by the District and made available to my child; and the educational materials to be used in the different educational program choices.

I understand that I must request that this waiver be reconsidered annually, each school year.

Parent/Guardian Signature: _____________________________ Date:______________

Address:______________________________________________________

City:__________________________ State:__________________ Zip:______________

Phone Number:___________________________

Waiver Granted/Denied:__________________________ Date:__________________

Signature: ________________________________

Exhibit ATASCADERO UNIFIED SCHOOL DISTRICT

version: March 7, 2000 Atascadero, California

PARENTAL EXCEPTION WAIVER

EDUCATION CODE 311