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Santa Maria-Bonita SD |  E  6141.4  Instruction

Program For English Learners   

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PARENTAL/GUARDIAN WAIVER REQUEST

I have been informed by the principal and educational staff that my child, ________________________ has been placed in a Sheltered English Immersion program at ________________________ School. I have personally visited my child's school and a description of the Sheltered English Learner program offered by the Santa Maria-Bonita School District has been provided to me. I am requesting that my child be removed from the Sheltered English Immersion program for the following reasons:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Because of the above noted reasons, I am requesting a waiver which will allow my child to be instructed in an alternative program. The alternative programs available to my child have been described to me. I understand that if I request a waiver into the English Mainstream program, this request will be granted immediately. I have chosen the following alternative program:

___________________________________________________________________

I understand that the school where my child is currently enrolled cannot guarantee that my child will receive the Parental Choice Alternative program that I am requesting. It has been explained to me that if the Parental Choice Alternative program is requested, my child may have to move to another class, to another track, or to another school in order to receive the Parental Choice Alternative instruction. I also understand that the transportation arrangements to a different school, if necessary, will not be provided by the Santa Maria-Bonita School District, unless otherwise required by law.

I understand that if school officials have recommended that my child be waived out of the Sheltered English Immersion program, I can refuse that recommendation and keep my child enrolled in the Sheltered English Immersion program.

I also understand that the waiver, if granted, will apply only to the current school year and that I must request a waiver on an annual basis. I understand that a decision will be made on my request within 20 instructional days of receipt of the waiver request by the principal, or within 10 calendar days after a 30 calendar day placement period, whichever is applicable.

Date: ________________________

________________________________________________

Parent/Guardian Signature

________________________________________________________________________

Print Child's Name) (Print Parent's/Guardian's Name)

Date received by Principal: ________

This is an exhibit only. ORDER AND USE FORM 1590F

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RECOMMENDATION OF THE PRINCIPAL AND EDUCATIONAL STAFF

After reviewing the reasons for the waiver request stated by the parents for this child, the recommendation of the educational staff and the criteria established by the Board of Education of the Santa Maria-Bonita School District for approval of such waiver requests, the Principal and Educational Staff have made the following decisions:

The Waiver request should be: Granted: Denied:

The recommendation is based on the following:

Under Section 311(a) of the Education Code, the Principal and Educational Staff have determined the student has good language skills as measured by standardized tests of English vocabulary comprehension, reading, and writing, in which he/she scores at or above the state average for this grade level or at or above the 5th grade level, whichever is lower.

Under Section 311(b) of the Education Code, the Principal and Educational Staff have determined that the student is ten (10) years old or older, and it is the informed belief of the Principal and Educational Staff that an alternative course of study would be better suited to the child's rapid acquisition of English language skills.

Under Section 311(c) of the Education Code, the Principal and Educational Staff have determined the student has physical, emotional, psychological or educational needs which constitute special needs that will be better served by an alternative program.

The criteria established by the Board of Education have been used by the Principal and Educational Staff in gathering evidence in support of their recommendation. That criteria are as follows:

1. The parents/guardians' level of participation and/or support in their child's education.

2. The child's level of success in the English Immersion program.

3. The child's progress toward grade level standards.

4. The child's history with the SST/IEP process.

5. The child's progress towards acquiring English-speaking skills.

6. The child's attendance profile.

7. List the Interventions that have been used.

8. Years in bilingual program: ________ Spanish Reading: ________

Transition: ________ FEP: ________

The Principal and Educational Staff have considered the criteria established by the Board of Education of the Santa Maria-Bonita School District in determining their recommendation regarding the parents/guardians' waiver request. A report to support our recommendation has been submitted to the Superintendent. We understand our recommendation will be reviewed by the Superintendent for final approval.

Date: ________________

________________________________________________

Principal's Signature

___________________________________________________________________

Educational Staff/Teacher's Signature Educational Staff/Teacher's Signature

Student's Name: ________________________ Grade/Track: ________

I have reviewed the waiver request for ________________________, a student in the Santa Maria-Bonita School District. After reviewing the reasons for the waiver request stated by the parents, the recommendation of the Principal and Educational Staff, the report of the Principal and Educational Staff, and the criteria established by the Board of Education of the Santa Maria-Bonita School District for approval of such waiver requests, I have made the following decision:

The waiver is hereby: GRANTED: DENIED:

I have made the above decision based on the following reasons:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

If the waiver was denied, you, the parent or guardian, have the right to appeal this decision to the Superintendent of the Santa Maria-Bonita School District if you disagree with it. Attached is a form outlining the procedures you are required to follow in order to appeal this decision. If you have any questions on the appeal process, do not hesitate to call either the Principal where your child is enrolled or the Superintendent's designee.

Respectfully,

Superintendent's Designee

of the Santa Maria-Bonita School District

For Superintendent's Designee's Use Only.

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SUPERINTENDENT'S RULING ON WAIVER REQUEST

I have reviewed the waiver request for , a student in the

Santa Maria-Bonita School District. After reviewing the reasons for the waiver request stated by the parents, the recommendation of the Principal and Educational Staff, the report of the Principal and Educational Staff, the criteria established by the Board of Education of the Santa Maria-Bonita School District for approval of such waiver requests, and the decision of the Superintendent's designee I have made the following decision:

The waiver is hereby: GRANTED: DENIED:

I have made the above decision based on the following reasons:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

If the waiver was denied, you, the parent or guardian, have the right to appeal this decision to the Board of Education of the Santa Maria-Bonita School District if you disagree with it. Attached is a form outlining the procedures you are required to follow in order to appeal this decision. If you have any questions on the appeal process, do not hesitate to contact the Principal where your child is enrolled or the Superintendent's designee.

Respectfully,

Superintendent of the

Santa Maria-Bonita School District

For Superintendent's Use Only.

Exhibit SANTA MARIA-BONITA SCHOOL DISTRICT

version: April 26, 2000 Santa Maria, California