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PARENT CHOICE STUDENT TRANSFERS WILL NOT …

PARENT CHOICESTUDENT TRANSFERS chool Year20____ - 20____NewRenewalRegion CenterDateTimeTransfer CodeAssigned school & Loc. No.(if applicable ):FM-3281E Rev. (04-18)I understand that transportation will not be knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his official duty shall beguilty of a misdemeanor of the second degree, punishable as provided in Chapter , , or Chapter (Chapter )DateDateParent's SignaturePrincipal's/Administrative Designee's SignaturePERCENTAGE OF FISH CAPACITY OF RECEIVING SCHOOLPERCENTAGE OF FISH CAPACITY OF SENDING SCHOOLRECOMMENDATIONAPPROVEDDENIED(Signa ture of Region Superintendent or Designee)(Date)FOR REGION CENTER USE ONLYR eviewed by.

PARENT CHOICE STUDENT TRANSFER School Year 20____ - 20____ New Renewal Region Center Date Time Transfer Code Assigned School & Loc. No. (if applicable):

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