SECTION 504 STUDENT ELIGIBILITY FORM

SECTION 504 STUDENT ELIGIBILITY FORM ... No, I do not consent for initial placement for my child for a 504 plan. Signature: Date: (parent/adult student/guardian) Signature: Date: (parent/adult student/guardian) III. Receipt of Parent/Guardian and Student Rights Yes No Rights were provided to the parent on _____ (date) by the building 504 ... ................
................