About this Form
Form number: 560-40A
Audience: School Staff
Last revised: January 2014
INSTRUCTIONS: Using the code definitions on the reverse side, complete for any student who resides in an informal kinship care relationship. Supporting documentation should be copied and attached. If there are no students, check the box that says “There are no student(s) attending who fall under section 4-122.1.” Forward to: Reports Specialist, CESC, Room 11.
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