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Westwood USD |  E  0520.2  Philosophy, Goals, Objectives and Comprehensive Plans

Title I Program Improvement Schools   

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PARENT/GUARDIAN TRANSFER REQUEST BASED ON SCHOOL'S PROGRAM IMPROVEMENT STATUS

Instructions: To request a transfer for your child out of a school that has been identified for [program improvement, corrective action or restructuring], please complete the following form and return it by [date] to [the district office or to the Superintendent/Principal at your child's school]. You will be notified by [date] regarding your child's school assignment for the next school year and your options if you decide to decline the school assignment at that time.

Child's Name: ______________________________________________________________

Parent/Guardian's Name: __________________________Signature: ___________________

School Child Currently Attends: ________________________________________________ Please write numbers in the boxes below to rank your top [number] choices of available schools:

[ ] __________________________[school name]__________________________

[ ] __________________________[school name]__________________________

[ ] __________________________[school name]__________________________

If you have any questions, please contact the [district office or Superintendent/Principal] at [phone number].

Exhibit WESTWOOD UNIFIED SCHOOL DISTRICT

version: August 21, 2009 Westwood, California

___________________________________________________________________________________

E(2) 0520.2

TITLE I PROGRAM IMPROVEMENT SCHOOLS

PARENT/GUARDIAN SELECTION OF

SUPPLEMENTAL EDUCATIONAL SERVICES

Instructions: To select supplemental educational services for your child, please complete the following form and mail, fax, or deliver it to the Superintendent/Principal of your child's school or to the district office by [date].

Student's Name: ___________________________ School: ___________________________

Parent/Guardian's Name: ____________________ Signature: ________________________ Please write numbers in the boxes below to indicate your top [number] choices of service providers:

[ ] ______________________[name of service provider]__________________________

[ ] ______________________[name of service provider]__________________________

[ ] ______________________[name of service provider]__________________________

[ ] ______________________[name of service provider]__________________________

Once a service provider has been determined for your child, the district will enter into a formal contract with the provider in accordance with law.

If you have any questions or need assistance selecting a provider, please contact [name] at [phone number].

Exhibit WESTWOOD UNIFIED SCHOOL DISTRICT

version: August 21, 2009 Westwood, California