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Request to Change Instructional Setting
This form is to be completed when conditions warrant a change for a student to move from face-to-face to virtual learning or vice-versa.
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* Indicates required question
Student Name
*
Your answer
Student ID
*
Your answer
Parent Email
*
Your answer
Best Contact Phone Number for Parent
*
Your answer
Grade Level
*
Your answer
Period 2 Or Homeroom Teacher
Your answer
Person Completing Form
*
Your answer
Student wishes to:
*
Move from virtual to face-to-face learning
Move from face-to-face to virtual learning
Reason for Request
*
Your answer
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