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PALISADES SCHOOL DISTRICT 39 Thomas Free Drive Kintnersville, PA 18930 REQUEST FOR HOMEBOUND INSTRUCTION Name of Student___ Address of Student___ Parent(s)/Guardian(s) Name___ Phone No.Home___ Business___

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How to fill out principal to request homebound

01

Complete the student's name, age, grade, and other personal information at the top of the form.

02

Provide a detailed explanation of the student's medical condition or circumstances requiring homebound instruction.

03

Include the requested start and end dates for the homebound services.

04

Obtain signatures from the student's parent or guardian, as well as a healthcare provider certifying the need for homebound instruction.

Who needs principal to request homebound?

01

Students who are unable to attend school due to a medical condition or other extenuating circumstances may need a principal to request homebound instruction.

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What is principal to request homebound?

The principal to request homebound refers to a formal application made by a school principal or authorized personnel to arrange homebound educational services for students who are unable to attend school due to medical or other legitimate reasons.

Who is required to file principal to request homebound?

The school principal or an authorized representative of the school district is required to file the principal to request homebound.

How to fill out principal to request homebound?

To fill out the principal to request homebound, one must complete the designated form by providing the student's information, reason for the request, duration of services needed, and signatures from the necessary parties, including the medical provider if required.

What is the purpose of principal to request homebound?

The purpose is to ensure that students who cannot physically attend school receive appropriate educational services in their home environment to continue their learning without interruption.

What information must be reported on principal to request homebound?

The report must include the student's name, address, date of birth, reason for homebound services, duration of absence, and any relevant medical documentation.

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