Fillable For the 2021-22 academic year, AB 104 bill

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For the 2021-22 academic year, AB 104 bill

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Colton Joint Unified School District
1212 Valencia Drive, Colton, CA 92324
AB 104 – Retention Consultation Request
For the 2021-22 academic year, AB 104 bill requires an LEA to offer the parent/guardian a
consultation upon receiving a written request to retain an eligible pupil.
“Eligible Pupil” is defined as a pupil who has received “deficient grades for at least one-half of
the pupil’s coursework in the 2020-21 academic year.”
Parent/Guardian:
Phone Number:
Student Name:
Student Number:
Grade (20-21 school year):
School:
Teacher(s)/Counselor:
Subjects:
Request for Retention Consultation In the area below, note anything else you would like
considered during the retention consultation.
Notes:
We, the parents/guardians of the above named student, request a retention consultation as our
student is an eligible pupil.
Parent/Guardian Signature:
Date:
12
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For the 2021-22 academic year, AB 104 bill

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Completed 3 August 2021

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