Accept or Decline Placement for the 2018-19 School Year

Please complete one form per student.

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Grade in 2018-2019 *

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Student Name *

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Intent for Next Year *

ACCEPT placement at the Open Classroom for the 2018-2019 School Year
DECLINE placement at the Open Classroom for the 2018-2019 School Year

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If accepting and your child has an IEP or 504 please provide the name of the school from which your child will be transferring.

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