minus foundation aid transportation payment / individual equipment / staff travel / /
Organization
Department of Public Instruction office of Special Education / Receiving School / B. School District of Residence Responsibility / SCHOOL BOARD / office of Special Education / School District of Residence / DEPARTMENT OF PUBLIC INSTRUCTION OFFICE OF SPECIAL EDUCATION SFN / Department of Public Instruction / School District of Residence’s Special Education Unit / D. School District of Residence Obligation / resident school district / School District of Residence Obligation / Applying School District of Residence / Address Administrator’s Telephone Number If receiving school district / /
Position
teacher / APPROVAL Admitting School District Administrator Signature Date SUPERINTENDENT OF PUBLIC INSTRUCTION APPROVAL Approval / Manager Signature Date / State Superintendent of Public Instruction SFN / President Signature Business Manager / Private / Superintendent / administrator / /
Microsoft Word[removed]Memo and Form2.doc