Request for On-Site Services
Franklin School will be providing targeted on-site support services available to those with specific needs. The school is limited on the number of students we can assist based on our availability of Chromebooks due to the students needing to be able to zoom with their teachers weekly.

All information provided will only be shared with Franklin Phonetic Primary School staff and will be kept confidential.

Please fill out one form per student. This is a request for On-Site Services and will be based on the students individual needs and first come first served basis Student capacity may be limited due to social distancing requirements. Once your request has been approved, you will receive an email on Friday indicating your acceptance as well as the waiver releasing Franklin School from liability that must be signed prior to your student being on campus. This form only needs to be submitted once.

This request must be received before 10AM on Friday in order to be considered for the following week.
Student's first name *
Student's last name *
Please select the grade the student is in *
Please select the reason you are requesting on-site services. *
Please explain any extenuating circumstances you may have that you would like us to consider.
I will need my child to attend the following days. *
Required
I understand drop off is between 7:50AM-8:20AM. We cannot allow late arrival. If you need to pick up your child early, please call to make arrangements. *
Please include a reliable email address. This is how you will be notified if your child is accepted into our On-Site services. *
I understand I will need to sign a liability waiver before my child can attend the On-Site services. The waiver will be emailed to you and you can either email it back or bring it with you on the first of attendance. *
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