Parent Signatures for Charter Petition
Answers to questions marked * will be included with the petition to the Kelseyville Unified School District Board. Answers to all other questions are for Shade Canyon's internal records only.
We the undersigned believe that the Charter for the creation of the Shade Canyon School (“Charter School”) merits consideration and hereby petition the governing board of the Kelseyville Unified School District to grant approval of the Charter pursuant to Education Code Section 47605 to enable the creation of the Charter School. The supporters listed below certify that they are parents or guardians who are meaningfully interested in having their children or wards attend the Charter School.
Name
*
First Name
Last Name
Signature
*
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Number of children entering grade TK-3, starting at Shade Canyon in 2022-23
*
Number of children entering grade TK-8, starting at Shade Canyon after 2022-23
*
Email (so we can send enrollment information when it's time)
example@example.com
Children's first names (for the Shade Canyon Origins painting)
Children's birth dates, mm/dd/yy (so we can estimate grade placement)
Submit
Should be Empty: