Blended Family Request to Change A/B Schedule
The purpose of the request is to allow students in the same household with different last names to be assigned the same school day.  If your household includes students with different last names, please complete the form by listing all students in the household enrolled in grades 6- 12.  You will receive an email stating which group your household has been assigned.  Waiver requests for reasons other than a blended family will not be approved.  
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Last Name of Parent/Guardian in Household *
First Name of Parent/Guardian in Household *
Email Address *
Telephone Number *
Student #1- First Name
Student #1 Last Name
Student #1 School
Student #1 Grade Level
Student #2- First Name
Student #2 Last Name
Student #2 School
Student #2 Grade Level
Student #3 First Name
Student #3 Last Name
Student #3 School
Student #3 Grade Level
Student #4 First Name
Student #4 Last Name
Student #4 School
Student #4 Grade Level
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