Print this form, complete it, and submit it to your child's school
If you request your high school student's grades be converted to Pass/Fail, print this form along with the AB 104 Request Form, and submit the two forms to your child's school.
AB 104 Pupil Instruction: Retention, Grade Changes and Exemptions
AB 104 allows for students who did not demonstrate satisfactory academic progress during the 2020-2021 school year to seek various supports.
If you would like to request any of the supports listed below, please print the AB 104 Request Form, fill it out, and submit it to your child's school.
| Grade Level in 20-21 | AB 104 Support Available |
| Kinder- 11th Grade |
Students in grades K-11 during the 2020-2021 school year with unsatisfactory letter grades (D or F) may request to have a consultation meeting to discuss being retained in the previous grade level. When this form gets submitted to your school site, the school will schedule a meeting to discuss your request and next steps. Please understand that a consultation meeting to discuss retention will not guarantee that your student will be retained. (BP5123) |
| Grades 9-12 |
High school students during the 2020-2021 school year may request to have one or more of their letter grades converted to Pass/Fail. Please understand that this change will not affect the student's GOA, but that some universities may not accept a grade of "Pass". If requesting this option, please include a copy of the Grade Change Form along with the AB 104 Request Form. |
| Grades 11 and 12 |
If the student was in the 11th or 12th grade in the 2020-2021 school year and failed to meet one or more classes needed to meet high school graduation requirements, and either did not graduate or is not on-track to graduate, the student may request to reduce the graduation requirements to the State minimum requirements for graduation. I understand that I may not be eligible to attend a 4-year university directly after high school and may first need to attend a community college. |
| Grades 11 and 12 |
If the student was in the 11th or 12th grade in the 2020-2021 school year and the student did not graduate or is not on-track to graduate, the student may request to remain in high school for a fifth year. |
