Prolouge

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Transfer Request        2011-2012        School Year

615 Snow Ave, Dallas, TX  75201         Ph:   214-546-0030                  Fax: 546-2144                               

STUDENT LEGAL NAME    Jason Charles Avery                 Birthdate    11-03-1996

PARENT/GUARDIAN NAME   Cherie Avery

Address  217 Sunflower Street    City    Dallas       State      Texas             Zip  75201

Home Phone   None          Work Phone   None           Cell Phone  228-342-5478

REQUESTING TRANSFER TO: School     Dallas High School               For Grade    9th

School Currently Attending    Hancock High School

REASON(s) FOR TRANSFER (Check all that apply)               □ Recent move & would like to remain    Attended requestted school last year                             □ Day Care                                                        □ Sibling(s) enrolled at requested school last year   Name(s)                      Grade(s)

Other      Jason's psychiatrist recommended we move him to a new school after being diagnosed with major depression and possible suicidal tentions after some bullying incidents at the old school.

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