APPENDIX B SAMPLE PARTICIPATION FORM North Dakota Department of Public Instruction This form MUST be returned to the school By Parent Name Student s Name Please review the enclosed brochure that provides a brief overview of the supplemental services provision. Please note the list of North Dakota-approved providers. Remember that participation is required* If your child does not attend the assigned services you will forfeit his/her eligibility and services will be offered to another interested family. Check one Yes I am interested in enrolling my child to receive supplemental education services. Please send me more information* No I am not interested in receiving supplemental services for my child. If you checked Yes and your child is identified as eligible you will receive more detailed information on North Dakota s State-Approved Supplemental Service Providers. Would you like the school to contact you to assist you in choosing a provider Yes. Please contact me at the telephone number....
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How to fill out the Participation Form Template online
This guide provides a clear and supportive overview of how to complete the Participation Form Template online. By following these steps, you will ensure accurate submission and understanding of the necessary information required.
Follow the steps to successfully complete the Participation Form Template
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Enter the parent’s name in the designated field to indicate who is submitting the form.
- Provide the name of the student(s) that this form is related to in the appropriate field.
- Review the enclosed brochure for information on supplemental services provision. Make sure to check the list of approved providers.
- Indicate your interest in enrolling your child for supplemental educational services by checking the appropriate box: either ‘Yes’ to request more information or ‘No’ if you are not interested.
- If you indicated ‘Yes’ in the previous step, select whether you would like the school to contact you for assistance with provider selection by checking the corresponding box.
- Fill in the signature field to authorize your submission, along with your address, city, telephone number, email, and state.
- Once all fields are completed, review the entries for accuracy before saving your changes, downloading, printing, or sharing the completed form.
Start completing your Participation Form Template online today!
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Does Microsoft have a form template?
Forms on Office Online Click this link to go to the Templates on Microsoft Office Online Web site, where you can browse for free form templates and template parts. To access this site, you must be connected to the Internet.
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