Class Schedule Change Request Form

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Jackson High School
Schedule Change Request Form
Name
Date
Grade
Counselor
Phone Number_____ _________________
Please follow the directions below. Failure to do so will result in having this form returned to you.
Please note that changes may not be completed prior to school opening. Top priority will
be given to students with schedules containing the issues listed below. Changes in
electives may not be granted due to class size, balance, and original requests being met.
Please know that some students have been scheduled into their first or second alternate
choice.
1. You have failed a class.
2. You have taken this class in the summer
3. You are a senior who needs a course to meet graduation requirements.
4. You have not met the prerequisite for a scheduled class.
5. There is a current health issue that requires a change in schedule.
6. Inappropriate academic placement.
7. If the placement was an error on the school’s part such as something you actually had not
requested.
CURRENT CLASS
REQUESTED CLASS
1
2
3
REASON FOR REQUESTING THIS CHANGE:
FORM IS NOT VALID WITHOUT PARENT SIGNATURE
Parent’s signature
__________________________________
Office Use Only
Approved__________
Denied ______________
Comments:

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