SHSD Inter-District Agreement RequestInter-District Agreement • August 31st, 2015
Contract Type FiledAugust 31st, 2015Requested District: Requested School: Program: (if applicable) School Year: 20 to 20 (one year only) Start Date: (if mid-year release) End Date: STUDENT INFORMATION (one form per student) Student: Legal name First Middle Last Birth Date: Grade Level: (of release year) Parent/Guardian: Email: (Required if student is younger than 18 at the time of this request) Phone (1): Current or Last School Attended: Phone (2): (Parent/Guardian contact if student younger than 18) Residence Address , WA City Zip Mailing Address (if different from residence) , WA City Zip REASON for REQUEST □ The student’s financial, educational, safety, or health conditions would likely be improved.□ Attendance in the nonresident district is more accessible to the parent’s/guardian’s place of work or to the location of child care.□ There is a special hardship or detrimental condition.□ The purpose of the release is for enrollment in an online course or school program offered by an OSPI-approved provider.□ Pa