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Intent to Return Form by zln29156

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									                                               Riverhead Charter School                         Board of Trustees
                                                   3685 Middle Country Road              James Leslie, Board President
                                                     Calverton, NY 11933                  Susan Heintz, Vice President
                                                    Phone (631) 369-5800               Harry Histand, Treasurer/Secretary
                                                    Fax     (631) 369-6687                   Donna Bloxon, Trustee
                                                                                            Lincoln Johnson, Trustee
                                               www.riverheadcharterschool.org               Angelo Nicholes, Trustee
                                                                                          Theresa Thompson, Trustee




                 Principal                                                                     Director of Operations
               Dorothy Porteus                                                                    Michelle Dalpiaz


                                                                           This form must be completed for each child
          January 25, 2010
                                                                                    planning to return to RCS
                                                                                  for the 2010-2011 school year
         Intent to Return Form

         It has been our pleasure to have your child attending Riverhead Charter School this past year. Your
         family and your child’s academic, social and emotional needs are very important to us. It is our hope and
         desire that your child(ren) will return to RCS for an exciting 2010-2011 school year!

         To help us plan our enrollment for next year, we must ask you to confirm that your child will
         return to Riverhead Charter School for the upcoming school year. We have a limited number of
         spaces available, so if you do not confirm that you are planning to return, we may have to release your
         child’s seat to a child on the waiting list.

         If your child will return, please mark “YES” and send this form back to school with your child. To hold
         a seat for next year, this form must be returned to your child’s teacher by February 26, 2010. Classrooms
         that have 100% of their forms returned by February 12 will be treated to a popcorn party.

         If you choose to send your child to another school, please mark “NO” and then provide us with the name
         of the new school. (Your feedback and honesty in replying why your child may not be attending is important to us.
         Please complete the information on the line below)


         Child’s Name: ________________________________________ Current Grade: _____

         q   YES! My child is returning to Riverhead Charter School next year.

         q   No, my child will not return.
             Name of new school: _______________________________________________________

             Reason for leaving RCS: __________________________________________________

         Parent/Guardian:          ___________________________________________________
         Home Address:             ___________________________________________________
         Home Phone: ________________________Cell Phone: _____________________
         School District in which you reside ____________________________________

         Parent’s Signature: ___________________________________                       Date: __________________




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