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