Short Term Independent Study Master AgreementShort Term Independent Study Master Agreement • March 17th, 2023
Contract Type FiledMarch 17th, 2023Student Information Student Name: ID# Grade: Address: Age: Birthdate: City and Zip Parent/Guardian: Parent/Guardian: School Enrolled: Primary Phone: District Residency: Are Siblings at other school sites requesting ST Independent Study as well? Yes No Program Placement: GED SPED* Other*Student’s IEP must specifically provide for enrollment into an Independent Study Program Reason for Independent Study: Travel Other Duration of Agreement(minimum three (3) and no more than fourteen (14) consecutive days per school year) Start Date: End Date: Assignments Due Date: Total Days of the Agreement: Supervising Teacher: Method of Instruction/Assignments Google Classroom: Yes No Paper Packet: Yes No