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Ted below (check appropriate reasons). q 1. The child is regularly enrolled in an alternative education program approved by the Board of Education of USD No. ______. q 2. The child is exempt pursuant to a court order which is attached to this form. q 3. The child and ______________________________________, the parent or person acting as a parent, have attended a final counseling session conducted by USD No. ______ and have signed a disclaimer, which is attached to this form. Signed ______.

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