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Substitutions for FHSP Graduation Requirements
Student Name:________________________________________
Student ID:_____________________________
Campus:_____________________________________________
District:________________________________
Language Other Than English (LOTE) Substitution
Student has completed one credit (1.0) of LOTE and is unlikely to be able to complete the second credit of the same LOTE and will substitute
another appropriate credit as follows:
o World History Studies or World Geography Studies (circle)
o Level I of Another LOTE:______________________________
o Special Topics in Language and Culture
o Computer Programming Languages
___________________________________________________
Signature of LOTE I Teacher & Date
Student is identified as Special Education or 504, and the student will substitute the second credit in LOTE with one of the options listed above.
____________________________________________________
Signature of Educational Diag./504 Coordinator & Date
________________________________________________________
Date of Committee Meeting
Student is identified as Special Education or 504 and, who due to a disability, is unable to complete two credits (2.0) in the same language in LOTE,
will substitute a combination of two credits (2.0) as follows:
o English/Language Arts, Mathematics, Science, or Social Studies: 1)____________________________ 2)___________________________
o CTE or Technical Applications: 1)_____________________________ 2)______________________________
____________________________________________________
Signature of Educational Diag./504 Coordinator & Date
________________________________________________________
Date of Committee Meeting
Physical Education (PE) Substitution
Student is unable to participate in physical activity due to disability or illness and will substitute an academic elective credit for the physical
education credit (1.0) as follows:
o English/Language Arts:_______________________________________________
o Mathematics:______________________________________________________
o Science:___________________________________________________________
o Social Studies:______________________________________________________
_____________________________________________________
Signature of Educational Diag./504/RTI Coordinator & Date
_________________________________________________________
Date of Committee Meeting
4th Science for Arts and Humanities Endorsement Substitution
Student is pursuing an Arts and Humanities Endorsement and is making the request to substitute a course for the 4th science as follows:
o English/Language Arts:_______________________________________________
o Social Studies:______________________________________________________
o LOTE:_____________________________________________________________
o Fine Arts:__________________________________________________________
Supporting Signatures for Substitution ( ** Verify college admission requirements have been researched)
_____________________________________________________
Signature of Student & Date
_______________________________________________________
Signature of Parent/Guardian & Date
_____________________________________________________
Signature of School Principal/Designee & Date
______________________________________________________
Signature of School Counselor & Date
WHITE – Cum Folder PINK – Counselor Folder YELLOW – Parent/Guardian BLUE – ARD/504 Folder