Cedar Park Elementary School by 1PHef8h0

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									                    Cedar Park Elementary School
                                      1101 Woodrow Avenue
                                      Selma, Alabama 36701
                                     Logan Cowart, Principal


                                   Title I Disclaimer

Student’s Name_____________________________________________________

School____________________________________________________________

Dear Parents,

  Your request for removal of your child rom the Title I reading and/or mathematics program can be
granted only by your signing and dating this form on the lines provided and returning this form to
the school.

                                          Sincerely,


                                          Logan W. Cowart, principal



I understand the purpose of the Title I program and decline these services for my child.


____________________________________                                       ________________
Parent/Guardian Signature                                                   Date

								
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