Transition to Hybrid Learning Request Form
This form should only be filled out by parents/guardians that wish to transition their child from the Virtual Only Instructional Model to the Hybrid Instructional Model (which includes in-person instruction 2 days a week). Parents/guardians should fill out a separate request form for each of their children.
Student's LAST Name:
Student's FIRST Name:
Which school does your child currently attend?
Mary F. Janvier School
Main Road School
Caroline L. Reutter School
Student Grade in 2020-2021 School Year:
Does your child currently have an Individualized Education Plan (IEP) and receive special education services?
Transportation-Please select one of the following choices below. If your child needs transportation on some days but not others, please select the first option.
My child will need to take the bus on the two in-person instructional days per week
I will provide alternate transportation for my child to and from school (only select this option if your child will not be riding the bus at all)
Parent/Guardian Email Address:
In completing this request your child will be reassigned from the Virtual Only Instructional Model to the Hybrid Instructional Model and requires your child to attend in-person instruction two days per week. Please review and acknowledge an understanding of the following before submitting: *Parents/guardians do not need to wait until October 1, 2020 to submit this request. *All requests will be honored but will be addressed on a first come, first serve basis. *Due to the complexity of scheduling, transportation limitations, and the individual needs of the student, placement may take up to two weeks to complete. *Only 1 instructional model change per trimester will be permitted. *A change from virtual only learning to hybrid/in-person instruction will likely result in a change in the student's schedule and teacher.
Yes, I acknowledge the information provided in the form and am requesting that my child be placed into the Hybrid/in-person instructional model.
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This form was created inside of Franklin Township Schools.