Florida Department of Education

Office of Independent Education & Parental Choice

Office of Independent Education & Parental Choice
 

 Office of Independent Education & Parental Choice 

Foster Intent Waiver Request Form
Florida School Choice- Foster Student
 

Student Information
*Student First Name:
Student Middle Name:
*Student Last Name:
*DOB:  
Social Security #:  
* Gender:  
* Current Grade:
* Race:



Hispanic/Latino:
*Last School Attended  
* Last School City  
* Last School State  
Current School District (if different)
Current School (if different)
* Does the student have an Individual Education Plan (IEP)?  
* Primary Exceptionality:  
* Does the student have a 504 accommodation plan with a duration of longer than 6 months?  
Qualifying Parent/Guardian
*Parent First Name:
* Parent Last Name:
*SSN:  
* Address1:
Address2:
*City:  
*State:  
*County:
* ZIP:  
* Email:  
*Home Phone:
Work Phone:
Contact Person (if different than qualifying parent/guardian)
First Name:
Last Name:
Address:
County:
City:
State:
ZIP:  
Home Phone:  
Work Phone:  
Email:  
Request Submitted By
* First Name  
* Last Name  
* Relationship to Student