Request for Schedule Change

  • SOUTH ALLEGHENY MIDDLE SCHOOL

    Guidance Department

     

    REQUEST FOR SCHEDULE CHANGE

     

    Student’s Name_____________________________________________________

    Grade:_______     Homeroom:__________          Home Phone No. _______________

    1.     Student, what is your schedule change request? Please be as specific as possible.

     

    The class I want to DROP                                                                                                       

     

    The class I want to ADD:                                                                                                         

     

    2.     Student, why do you want this schedule change?

     

     

    3.     Student, what have you done to improve your grade?

     

                            ___Consultation with the school counselor

                            ___ Student/Teacher meeting

                            ___ Parent/Teacher meeting     

                            ___Tutor Assignment (SA BUSTERS/Study Island)

                            ___ Study Skills Group

                            ___ Other                                                                                                                   

     

    4.     Signatures of Approval:

     

    STUDENT, please understand that some schedule changes simply cannot be made. We will do our best to accommodate appropriate changes which are in your best interest.

     

    STUDENT’S SIGNATURE                                                    Date                                        

     

    PARENTS, please understand that some schedule changes simply cannot be made. We will do our best to accommodate appropriate changes which are in the best interests of your student.

     

    I ___ APPROVE/___DISAPPROVE of this change in my student’s schedule.

     

    PARENT’S SIGNATURE                                                       Date                                        

     

                Student is in Learning Support or has a Service Agreement:           ___Yes                        ___No

     

                DIRECTOR OF SPECIAL ED’S SIGNATURE                                                Date                            

     

                ---------------------------------------------------------------------------------------------------------------------

    (Please See Reverse: Incomplete forms cannot be processed.)

     

     

     

    Student’s Name:                                                                                                                                   

     

    Current Teacher, your input is required to process this form. It is our hope that this requirement will foster a dialogue with the student regarding appropriate placement and strategies for success.

     

    Student’s Current Percentage Grade in the Course:                    

     

    I            APPROVE/                 DISAPPROVE of this change to the student’s schedule.

     

    (If teacher disapproves the change, a parent/student/counselor/teacher conference will occur.)

     

    CURRENT TEACHER’S COMMENTS:                                                                                             

     

                                                                                                                                                               

     

    Textbook must be returned by:                                                  

     

    Current Teacher’s Signature:                                                                 Date:                                       

                                                                                                                                                               

     

    Receiving Teacher, your input is required to process this form. It is our hope that this requirement will foster a smooth transition to your class, should you approve the placement.

     

    Number of students in class once the student is added:                          

     

    I           APPROVE/                 DISAPPROVE of this change to the student’s schedule.

     

    RECEIVING TEACHER’S COMMENTS:                                                                                        

     

                                                                                                                                                               

     

    Receiving Teacher’s Signature:                                                  Date:                                       

                                                                                                                                                               

     

    COUNSELOR SECTION

     

    This schedule or level change request will be considered based upon the existing Schedule Change Policy articulated in the Student Handbook. Should the student request be approved by both sending and receiving teachers, every attempt will be made to grant the change with the least possible disruption to the student’s existing schedule. However, some schedule changes simply cannot be granted because of confines and restrictions in the master schedule—the student will be notified if his/her request cannot be granted for this reason.

     

    Counselor’s Signature:                                                  Date Received:                        

    Schedule Change                      APPROVED                            DISAPPROVED