School of Attendance. A student with a disability will be educated in the school as close as possible to the student’s home and unless the IEP requires some other arrangement, the student is educated in the school he or she would attend if not disabled.
School of Attendance. EAGLE ROCK JR/SR HIGH SCHOOL (9 TO 12) Program Applying for: (only check one) Before-School Afier-School Other Programs Ready-Set-Go (RSG) Youth Service Grant Funded Program (ASES/21* CCLC/ASSETs □ D Nameof Program A WORLD FIT FOR KIDS! Name of Program□ APPLICANT (PLEASE WRITE IN BLUE OR BLACK INK ONLY) Print Name CLEARLY Arst M.I. Last Date of XxXx Month Day Year Grade Street Address APT# City Zip Code PARENT(S)/ GUARDIAN($) Patents/ Guardian's Name Parents/ Guardian's Name Print Name: First Phone Number (Main} M.I. Last Phone Number (Other) Print Name: Phone Number (Main) First M.I. Last Phone Number (Other) EMERGENCY CONTRACT/ RELEASE Information (provide a minimum of two contacts) #1: Relationship Name (First Name) Phone Number(s) Address (Street, City, Zip Code) #2: Relationship Name (First Name) Phone Number(s) Address (Street, City, Zip Code) #3: Relationship Name (First Name) Phone Number(s) Address (Street, City, Zip Code) • I/We authorize the Beyond the Bell Before/After-School Program (BASP) to contact, and If necessary. release my child to any of the above Individuals listed as an Emergency Contact/Release Information. The above listed individuals must be 18 years or older. • I/We give my permission for my child to be fllmed or photographed. I understand that all film or photos are the sole property of the BASP, and may be used In displays to the public, to publicize the program, or for printed materials published by and/or for the BASP. • I/We hereby consent to the disclosure of personally Identifiable Information from my child's education records under the Family Educational Rights and Privacy Act and allow for the Los Angeles Unified School District to disclose such Information only to the extent and for the duration necessary for my child to participate In BASP programs. □ □ • The After-School Education and Safety (ASES) Program Act of 2002, enacted by Initiative statute, establishes the After School Education and Safety Program to serve pupils In kindergarten and grades 1 to 9, Inclusive, at participating public elementary. middle, Junior high, and charter schools. The act gives priority enrollment in aGer school programs and before school programs to pupils in middle school or junior high school who attend daily. Pupils who are Identified by the program as homeless youth or as being In xxxxxx care will be given first priority. Parents/guardians may indicate this Information below: Pupil designation (please check If applicable): Homeless Y...
School of Attendance. The district reserves the right to transfer XXX students between schools if space is not available at a given site. I/We (Parent and Student) have read the above terms and conditions and agree that I/we are bound by them and are expected to meet all of the above criteria. I/We understand that the permission of the student to attend school in Xxxxxx USD will be revoked for failure to meet the requirements set forth herein. I/We declare under penalty of perjury under the laws of the State of California that all of the information on this application is true and correct and I/we understand that any willfully inaccurate information provided in this application will be grounds for immediate denial or revocation of the Inter District Attendance Agreement. Name/Signature: (Parent / Guardian Name and Signature) Name/Signature: (Student’s Name and Signature) Date: Date: Note: Parent may sign for student but takes the responsibility of reviewing the contract with their child.
