MUST BE FILLED OUT BY MONDAY AUGUST 17, 2020. ONE MUST BE FILLED OUT FOR EACH CHILD THAT YOU HAVE! DEBE LLENARSE ANTES DEL LUNES 17 DE AGOSTO DE 2020. ¡DEBE COMPLETAR UNO POR CADA NIÑO QUE TENGA!

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PARENT FIRST NAME, LAST NAME /PRIMER NOMBRE DEL PADRE, APELLIDO *

CHILD'S FIRST NAME /EL PRIMER NOMBRE DEL NIÑO/A *

CHILD'S LAST NAME/ APELLIDO DEL NIÑO/A *

CHILD'S GRADE/ GRADO DEL NIÑO/A *

I WANT TO KEEP MY CHILD HOME AND LEARNING REMOTE FOR THE ENTIRE SCHOOL YEAR/ QUIERO MANTENER A MI HIJO/A EN CASA Y APRENDER A DISTANCIA DURANTE TODO EL AÑO ESCOLAR *

Yes/ Si

No/ no

DOES YOUR CHILD RECEIVE SPECIAL SERVICES?/ ¿RECIBE SU HIJO SERVICIOS ESPECIALES?

Yes/Si

No/No

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