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Woodside ESD |  E  6173  Instruction

Education For Homeless Children   

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DISTRICT EXPLANATION OF ENROLLMENT DECISION

Instructions: The following form is to be used when the district has denied a parent/guardian's enrollment request.

Date:______________ Name of person completing form:

Title: Phone number:

In accordance with federal law (42 USC 11432), this notification is being provided to:

Name of parent/guardian:

Name of student(s):

District's placement decision (name of school):_____________________________________

After reviewing your request to enroll your child in the school listed above, your enrollment request has been denied. This determination was based upon:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If you are not satisfied with the Superintendent's decision, you may appeal to the ______(county name)_________ County Office of Education. If you are not satisfied with the county office's decision, you may then appeal to the California Department of Education. The district's homeless liaison can assist you with this appeal.

Name of district's homeless liaison:

Address:

Phone number:

Name of County Office of Education homeless liaison:

Address:

Phone number:

You also have the following rights:

* Pending resolution of this dispute, your child has the right to immediately enroll in the district school and to participate in school activities at the school.

* You may provide written or verbal documentation to support your position. You may use the district's dispute resolution form. A copy of the dispute resolution form can be obtained from the district's liaison for homeless students.

* You may seek the assistance of advocates or attorneys to help you with this appeal.

Exhibit WOODSIDE ELEMENTARY SCHOOL DISTRICT

version: February 12, 2013 Woodside, California

________________________________________________________________

Exhibit 2 6173

EDUCATION FOR HOMELESS CHILDREN

ENROLLMENT DISPUTE FORM

Instructions: This form is to be completed by a parent/guardian or student when a dispute regarding enrollment has arisen. As an alternative to completing this form, the information on this form may be shared verbally with the district's liaison for homeless students.

Date submitted:

Name of person completing form:

Student's name:

Relation to student:

I may be contacted at the following:

Address:

Phone number:

Name of school requested:

I wish to appeal the enrollment decision made by:

District liaison County liaison

Reason for the appeal: You may include an explanation to support your appeal in this space or provide your explanation verbally.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

___________________________________________________________________________

I have been provided with:

A written explanation of the district's decision

Contact information for the district's homeless liaison

Contact information for the county office of education's homeless liaison

Exhibit WOODSIDE ELEMENTARY SCHOOL DISTRICT

version: February 12, 2013 Woodside, California