Charles Street School Transition Form between Remote & Hybrid Instruction 2020-2021
Please complete this form to request a change in instructional models for your child. A separate form needs to be completed for each student.
Parent Name: *
Parent Email: *
Student Name *
Student Grade *
I am requesting that my child transfer...
To Hybrid
To Remote
From Remote
From Hybrid
Technology (check all that apply) *
My child receives Special Education Services: *
Please state any concerns you may have regarding the impact switching instructional models may have on your child’s services:
The building principal will review your request for compliance with Palmyra BOE Policy 1648.02 and you will be notified in writing regarding its approval status.
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