raj FCC? Submit this completed and signed form to the Department of Student Services, 3308 Forest Hill Boulevard, C-143, West Palm Beach, FL 33406-5869. School Transportation Is NOT PROVIDED by the Palm Beach District Schools to students who are granted reassignment Reassignment approval does not guarantee eligibility for athletic teams or other extraairricular activities. Contact your principal for information about eligizility. School reassignment is subject to change by Student Services during review. Student may be returned to the school in his/her assigned attendance area if: • he/she becomes a discipline and/or attendance problem. 45 3 s THE SCHOOL DISTRICT OF PALM BEACH COUNTY 6g lo, DEPARTMENT OF STUDENT SERVICES Student Reassignment ApplicationL9 ty 17 /00 • the student's parent or guardian Is unable or unwilling to work cooperatively with the policies and procedures of the reassired school, • the reasons for reassignment are no longer valid or the school's utilization exceeds 100%. This form Is not valid unless signed by parent or legal guardian. Student Reassignments will be reviewed annually. I an, I rmar, arm. I mar, le Student Is requesting to be reassigned to (name of school) 120.---k k.--) /ft% What is the school attendance area in which the student now lives? 23 t S,33 )/ v \ is3/ Does the student currently have a reassignment? 0 Yes 0 No What is the reason the student is requesting reassignment (choose an that apt* K R 0 Moving into Attendance Zone (enclose valid proof) Supervision Hardship -Grades K-5 (Parent Employment Verification and Year Reassignment Supervision Hardship P850 0879 must be attached) K Health Reasons** 0 Into County High hod Schedule Compatibility (Gummi year only) ❑rowialn tow) °The Student Reassignment Health &merlon form PBSI7 1893 must be completed by physician and attached. — State specific reason(s) why reassignment Is being requested to school listed above:, .p he eYTTe( cir -the sc