Transcription of ENROLLMENT / EXCLUSION FORM Follow …
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ENROLLMENT / EXCLUSION FORMTo Implement Sections 16-28-40 through 16-28-45, Code of Alabama, 1975 Follow instructions on the back of this form. Print or type all APPLICANT*Sex:Social Security No.:Driver's License No.:Male/FemaleDate of Birth:Legal Name:LastMiFirstMM/DD/YYAddress:StateZip CityStreet11. ENROLLMENT * SCHOOL OR GED OR JOB TRAINING PROGRAMC heck one:GED ProgramName:Job Training Program(School or in GED or Job Training Program)Secondary SchoolAddress:StateCityZipStreetSignatur e:Telephone No.:Title:Enter the actual date of compliance or noncompliance in the blank located to the left of the appropriate IN COMPLIANCEIN COMPLIANCEThe applicant:The applicant:Is not accumulated more than 10 consecutiveor 15 cumulative unexcused absences duringWithdrew due to circumstances beyondhis or her control.
ENROLLMENT / EXCLUSION FORM To Implement Sections 16-28-40 through 16-28-45, Code of Alabama, 1975 Follow instructions on the back of this form.
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