2021-2022 13.97 RENEWAL of Hardship Out of Zone Transfer Application

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VALID FOR 2021--2022 SCHOOL YEAR ONLY

Student's First Name *

Student's Middle Name

Student's Last Name *

Grade in 2021-2022 School Year *

Student ID Number *

Current School (2020-2021) *

2021-2022 Zoned School *

2021-2022 Requested School *

Is your child currently staffed in a Exceptional Education Program? *

Yes

If YES, what program?

Have there been any significant changes to the hardship reason you provided last year? *

Yes

If YES, please provide new information below:

Reason for Request - additional information *

(Please provide additional information concerning your request and if OTHER School was selected above, please provide name and location of current school.)

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