Escondido Union School District
San Marcos Unified School District
Intradistrict/Interdistrict Permit Verification of Child Care K-6 /Employment K-12
This form must be completed for all transfers, which are based on the need for childcare or employment.
A. TO BE COMPLETED BY PARENT School Year
School/District of desired attendance /
Pupil’s name Grade
Last First Middle
Reason for attendance at this location: Childcare Employment
Explain
Print name Signature Date
(Parent/Guardian) (Parent/Guardian)
Address Home Telephone #
City Zip Work Telephone #
B. TO BE COMPLETED BY CHILD CARE PROVIDER
Child for which care will be provided
Name of child care provider
Address Telephone #
City Zip Date
Relationship to child (if any)
Date care will start Hours: FROM a.m./p.m. TO a.m./p.m.
I agree to notify San Marcos Unified School District (760) 752-1220 when these arrangements are terminated.
Date Signature Title
C. TO BE COMPLETED BY EMPLOYER
Parent/Guardian’s Name:
Place of employment City
Length of employment Number of hours per day
Name of person verifying employment Telephone#
Date Signature/Seal Title
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