South Dakota

*This letter is the filled-companion to the Department of Education's standard Alternative Instruction Notification form. File the form itself — online (which notifies the Department and your district at once) or on paper to the Department or your district's main office — and keep the signed or stamped copy returned to you as proof of notification. SDCL 13-27-7 does not allow the form to require more than the contents below.* --- ALTERNATIVE INSTRUCTION NOTIFICATION SDCL 13-27-3 · SDCL 13-27-7 To: [SOUTH DAKOTA DEPARTMENT OF EDUCATION / NAME OF LOCAL SCHOOL DISTRICT] Student information (one notification per student): - Child's name: [FIRST, MIDDLE, LAST NAME] - Date of birth: [DATE OF BIRTH] - Resident district: [DISTRICT] - Open enrolled district (if an open enrollment application has been accepted): [DISTRICT OR "NONE"] I declare that the child named above will be provided with alternative instruction as outlined in SDCL 13-27-3, beginning with the [SCHOOL YEAR] school year. I am the parent, guardian, or other person having control of the child. I will update this child's record within 30 days if the child enrolls in a public or nonpublic school or moves to a different school district. Return of form — send my copy to: [EMAIL ADDRESS / MAILING ADDRESS] Name of parent / guardian (print): [NAME] Signature of parent / guardian: ______________________________ Date: ______________ *(To be completed by the Department of Education or the district: official's name, organization/district, signature, date received, date copy sent to parent/guardian.)*