Request for Release from Clinton City Schools
REQUEST *
STUDENT'S FIRST NAME *
STUDENT'S MIDDLE NAME
STUDENT'S LAST NAME *
IN WHAT SCHOOL SYSTEM/SCHOOL IS YOUR CHILD PRESENTLY ENROLLED? *
SCHOOL YOUR CHILD SHOULD ATTEND *
PARENT/GUARDIAN(S) FIRST NAME *
PARENT/GUARDIAN(S) LAST NAME *
MAILING ADDRESS (STREET, CITY, STATE, ZIP CODE) *
HOME OR CELL TELEPHONE NUMBER *
WORK TELEPHONE NUMBER
REASON FOR REQUEST
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