Common use of Reason for Request Clause in Contracts

Reason for Request. □ The student’s financial, educational, safety, or health conditions would likely be improved. □ Attendance in the nonresident district is more accessible to the parent’s/guardian’s place of work or to the location of child care. There is a special hardship or detrimental condition. The purpose of the release is for enrollment in an online course or school program offered by an OSPI-approved provider. Parent/guardian is an employee with the requested school district. Does the student have a record of conviction of crimes, violent or disruptive behavior or gang membership? □ Yes □ No Has this student been expelled or suspended for more than 10 consecutive days? □ Yes □ No Has the student repeatedly failed to comply with requirements for participation in an online school program, such as participating in weekly direct contact with the teacher or monthly progress evaluations? □ Yes □ No Has the student and/or parent had any formal meetings with school officials regarding school attendance issues in the past two years? □ Yes □ No Is this student under a court order to attend school or is a truancy petition in the process of being filed? □ Yes □ No Does this student qualify for Special Education services? (Must have an active IEP and a current evaluation) □ Yes □ No After completion of the placement test, does this student qualify for TBIP (Transitional Bilingual Instruction Program) services? □ Yes □ No Does this student qualify as Exited TBIP? (To qualify, the student was receiving TBIP services in the previous school year and/or current school year, and scored a Level 4 in the annual WELPA test in either the spring of those years.) □ Yes □ No Primary district whom is responsible for annual assessments and the portion of FTE each district is to claim for the student.

Reason for Request. □ The student’s financial, educational, safety, or health conditions would likely be improved. □ Attendance in the nonresident district is more accessible to the parent’s/guardian’s place of work or to the location of child care. There is a special hardship or detrimental condition. The purpose of the release is for enrollment in an online course or school program offered by an OSPI-approved provider. Parent/guardian is an employee with the requested school district. BEHAVIOR (attach sheet with explanation for any yes answers) Does the student have a record of conviction of crimes, violent or disruptive behavior or gang membership? □ Yes □ No Has this student been expelled or suspended for more than 10 consecutive days? □ Yes □ No Has the student repeatedly failed to comply with requirements for participation in an online school program, such as participating in weekly direct contact with the teacher or monthly progress evaluations? □ Yes □ No Has the student and/or parent had any formal meetings with school officials regarding school attendance issues in the past two years? □ Yes □ No Is this student under a court order to attend school or is a truancy petition in the process of being filed? □ Yes □ No Does this student qualify for Special Education services? (Must have an active IEP and a current evaluation) □ Yes □ No After completion of the placement test, does this student qualify for TBIP (Transitional Bilingual Instruction Program) services? □ Yes □ No Does this student qualify as Exited TBIP? (To qualify, the student was receiving TBIP services in the previous school year and/or current school year, and scored a Level 4 in the annual WELPA test in either the spring of those years.) □ Yes □ No Primary district whom is responsible for annual assessments and COURSES REQUESTED (Include course or coursework description, credit, % of the portion of FTE each district is to claim for the studentday, etc.) Resident School Nonresident School Grades K-12                     Skill Center                     Running Start                    

Reason for Request. □ The student’s financial, educational, safety, or health conditions would likely be improved. □ Attendance in the nonresident district is more accessible to the parent’s/guardian’s place of work or to the location of child care. □ There is a special hardship or detrimental condition. □ The purpose of the release is for enrollment in an online course or school program offered by an OSPI-approved provider. □ Parent/guardian is an employee with the requested school district. Does the student have a record of conviction of crimes, violent or disruptive behavior or gang membership? □ Yes □ No Has this student been expelled or suspended for more than 10 consecutive days? □ Yes □ No Has the student repeatedly failed to comply with requirements for participation in an online school program, such as participating in weekly direct contact with the teacher or monthly progress evaluations? □ Yes □ No Has the student and/or parent had any formal meetings with school officials regarding school attendance issues in the past two years? □ Yes □ No Is this student under a court order to attend school or is a truancy petition in the process of being filed? □ Yes □ No Does this student qualify for Special Education services? (Must have an active IEP and a current evaluation) □ Yes □ No After completion of the placement test, does this student qualify for TBIP (Transitional Bilingual Instruction Program) services? □ Yes □ No Does this student qualify as Exited TBIP? (To qualify, the student was receiving TBIP services in the previous school year and/or current school year, and scored a Level 4 in the annual WELPA test in either the spring of those years.) □ Yes □ No Primary district whom is responsible for annual assessments and the portion of FTE each district is to claim for the student.No