Harrison County Schools SB 128 Supplemental Instructional School Year Application
This document is the DISTRICT application for the intent to pursue an additional school year pursuant to SB128. This is the first step in the supplemental year process. Filling out this form does not supersede the process and protocols outlined by your child's school. If you have selected this option this child's school will contact you with further steps. SB 128 can be found in its entirety at this link:
https://apps.legislature.ky.gov/record/21rs/sb128.html
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Today's Date: (All Applications/requests MUST be submitted by May 1, 2021 per SB128 Subsection 4)
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Student's Last Name
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Your answer
Student's First Name
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Your answer
School your student currently attends:
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Choose
Eastside Elementary
Northside Elementary
Southside Elementary
Westside Elementary
Harrison County Middle School
Harrison County High School
Your student's current grade level for THIS school year (2020-2021):
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Choose
K
1
2
3
4
5
6
7
8
9
10
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12
Parent/Guardian's Last Name:
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Your answer
Parent/Guardian's First Name:
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Your answer
Parent/Guardian's Cell/Home Phone Number: (Please include area code)
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Your answer
Disclaimer: I acknowledge that SB128 affords my child an additional supplemental year of instruction. I further acknowledge that in compliance with KRS 156.070(2)(f), my student will be ineligible for extracurricular activities governed by the KHSSA if they reach the age of 19 on or before August 1st. *If you have questions please contact your child's school.
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I understand and accept the above statement
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