DHMS- Student NOT Returning for the 2022/2023 School Year
*We still require a signed Release of Records from the new school
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Student's Last Name *
Student's First Name *
Student ID# *
Student's Grade Level for the 2021/2022 School Year *
NEW Home Address (to include city, state and zip code) *
NEW School's Name *
NEW School's Address (to include city, state, and zip code) *
Type of School *
NEW School Contact Information (to include Name, Email and Phone Number) *
Does your student have an IEP? *
Does your student have a 504 Plan? *
Parent/Guardian First and Last Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
Please type the following statement: I give DHMS permission to share any requested documents to the school listed above. *
Parent/Guardian Initials *
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