CLARK COUNTY SCHOOL DISTRICT SENIOR ACADEMIC LOAD EXEMPTION FORM

CLARK COUNTY SCHOOL DISTRICT SENIOR ACADEMIC LOAD EXEMPTION FORM
Student Name

First NameLast Name
Student Number
School Name
Counselor Name
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
Good Cause Exemption Reason

Works where income supports his/her family. Adding classes would reduce the hours the student works and thereby reduce the student's needed support for the family.Primary caregiver of children in the family after school or student is a parent of one or more children. Adding courses to the student's schedule would cause additional hardship/costs to the family by having to hire outside childcare.Primary caregiver of an infirm parent/family member. Adding courses will cause the family hardship/costs to provide care by an outside provider if the student is not available.Has an IEP or 504 that states the student be enrolled in a reduced academic load.
Should be Empty: