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Vallecito Un SD |  E  6174  Instruction

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PARENTAL EXCEPTION WAIVER

EDUCATION CODE 311

Student's Name: Grade:

School: Date of Birth:

Student's Primary Language:

I request a waiver of the placement of my child in the school's structured/sheltered English immersion program for the following reason:

__ My child possesses good English language skills. (Education Code 311(a))

__ 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. (Education Code 311(b))

__ I believe that my child has special needs and that an alternate course of study is better suited to his/her educational development. (Education Code 311(c))

I understand that the objective for my child is to be taught English as rapidly and effectively as possible. 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 have personally visited the school to apply for this waiver.

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:

For waivers pursuant to Education Code 311(a), student'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:_________________________________ Title: ___________________________

Exhibit VALLECITO UNION SCHOOL DISTRICT

version: October 16, 2013 Avery, California