Football Scrimmages Friday

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This story was printed from Royal Valley, USD 337.
Site URL: http://www.rv337.com.

Textbook Waiver Form 2006-07

by Barb Williamson
June 01, 2006

______________________________________, the parent/guardian of the following child(ren):

Parent/Guardian

Name Grade

______________________________________________ ______________

______________________________________________ _______________

requests that the payment of the textbook fee for the 2006-2007 school year be waived due to the following extenuating circumstance: (Please be specific)

_________________________________________________________________________________

_____________________________________________ ________________

Parent/Guardian Date

------------------------------------------------------------------------------------------------------------------

Waiver is granted ___________________________________ __________________based on income School Official Date

eligibility guidelines and circumstance listed above

Waiver is NOT granted __________________________________ __________________

based on income School Official Date

eligibility guidelines and/or circumstance listed above

See the building administrator to work out a suitable payment plan.

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