Spearfish School District 40-2
5000 Students

Code: 5210.3FM

                                        STUDENT SUSPENSION/EXPULSION WAIVER

I hereby waive my right to a hearing in the matter of potential suspension or expulsion from school for the alleged misconduct of ____________________________________________________.

Said hearing was set for the _________ day of _______________, 2________.

Dated this ______________________ day of _____________________, 2______.

_____________________________________________________
Student

______________________________________________________
Parent, Guardian or other Responsible Person