MIDDLE SCHOOL ASSIGNMENT APPEAL FORM

MIDDLE SCHOOL ASSIGNMENT APPEAL FORM
Middle school assignments for all incoming grade 6 students were completed in accordance with the Brockton School Committee guidelines. If you are not satisfied with your child’s middle school assignment, you will be able to make a ONE-TIME appeal. A three-member appeal panel will review such cases. The Appeals Board will consider only those requests which are deemed sufficiently compelling and which can be accommodated within available space. The decision of the Appeals Board is final.
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STUDENT'S NAME

First NameLast Name
STUDENT'S DATE OF BIRTH

MonthDayYear
Date
STUDENT ID NUMBER
26-27 ASSIGNED SCHOOL
GRADE
CURRENT SCHOOL ZONE
PREFERRED SCHOOL
BASED ON SEAT AVAILABILITY
DESIRED SCHOOL ZONE
REASON FOR APPEAL
TRANSPORTATION IS NOT A VALID REASON FOR AN APPEAL.
PARENT/GUARDIAN NAME

First NameLast Name
PARENT/GUARDIAN EMAIL
example@example.com
PARENT/GUARDIAN CELL PHONE
Please enter a valid phone number.Format: (000) 000-0000.
HOME ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PARENT/GUARDIAN SIGNATURE
UPLOAD PARENT/GUARDIAN PHOTO ID

Cancelof
Should be Empty: