BASD Learning Pathway Transition Request (Grades 7-9)

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If you would like to transition your child from one Learning Pathway to another, please complete this request form. Somebody from the school will be in touch to discuss your child's transition plan and timeline.

Student's Last Name *

Student's First Name *

Parent/Guardian's First and Last Name *

Parent/Guardian's Email *

Parent/Guardian's Phone Number *

Student's Home Address *

Is the student currently enrolled in Butler Area School District? *

Yes

What grade is your child currently in? *

What school does your child attend (or would they attend)?

Intermediate High School

Center Avenue Community School

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Does the student receive special education services? *

Yes-IEP

Yes-GIEP

Yes-504 Service Agreement

Please select your child's guidance counselor for the 2020-2021 school year. *

Mrs. Jennifer Misencik (Grade 7- Butler Intermediate High School)

Mrs. Mary Caton (Grade 8- Butler Intermediate High School)

Ms. Lisa Philipkosky (Grade 9- Butler Intermediate High School)

Mrs. Shannon McGraw - College Tech Prep Coordinator

Mr. Tom Long-(for Center Avenue Students)

The Learning Pathway in which my child is currently enrolled is the: *

Traditional School Model (Full time in person instruction at school. Note: this automatically became the COHORT model when that was the school's mode of operation.)

Online/Cyber School Model (Full time remote learning at home through the Cyber Learning Program)

The Hybrid School Model (Some courses in person at school and some courses remotely at home. Note: this automatically became the COHORT model when that was the school's mode of operation.)

Remote Instruction/Live Stream (Remote instruction/livestreaming full time while the COHORT model was operating).

New student/ new enrollment in Butler Area School District

The Learning Pathway I would like my student to transition to is the: *

Traditional School Model (Full time in person instruction at school. Note: this automatically becomes the COHORT model when that is the school's mode of operation.)

Remote/Live Stream full time through the remainder of the year.

Maintain COHORT in-person attendance days. (Two days in person at school and three days of remote instruction at home. Remain in the White/Gold Cohort schedule with remote instruction on Friday).

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