2020-2021 Instructional Model Change Request-Pembroke Pines K-12 (HS)
Please submit this form for your scholar to move into a different instructional model at the next available change window. Please note the following:
-Changes from AFAR to FLEX or LIVE may only be done during the designated change windows.
-Changes from FLEX or LIVE to AFAR may be done at any time and will be effective within 48 hours of the request. These requests should be submitted via email to Astrid Ortiz-Rivera.
-By submitting this request you understand that a change to your scholar's current instructional model may cause his or her schedule and/or teachers to be changed. This is at administration's discretion to maintain the safety of all students and teachers on campus and provide appropriate instruction for all.
-By submitting this form, you understand and acknowledge that should the request for on-campus instruction exceed the current number of students in your child’s class, six-foot distancing may no longer be possible.

CHANGE REQUESTS FOR QUARTER 3 MUST BE SUBMITTED BY DECEMBER 18 THROUGH THIS FORM AND WILL GO INTO EFFECT JANUARY 11.

You will receive a confirmation of your form's submission automatically. When the change window takes effect you will receive confirmation from Mrs. Rivera regarding your scholar's move to his or her new instructional model. Please submit any questions regarding this change to Mrs. Rivera at ortiz-rivera.astrid@Franklin-Academy.org. 
Sign in to Google to save your progress. Learn more
Email *
Student First Name *
Student Last Name *
Parent/Guardian submitting request *
Current Instructional Model *
Desired Instructional Model *
I understand that this change may require my scholar to change his or her teacher(s) or schedule. *
If your scholar's schedule or teachers will change as a result of this switch in instructional models, do you still want to go through with the request? *
I have read and agree to follow Franklin's Student Policy Related to COVID-19 including the student use of masks while on campus. *
Does or will your scholar have a sibling attending on-campus instruction at the Pembroke Pines K-12 campus? *
If yes, list name of sibling(s)
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Franklin Academy. Report Abuse
Google Forms