Boundary Request Application 2017-2018
To be used for in-district and out of district requests
Student's First Name *
Your answer
Student's Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Current Grade *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
City *
Your answer
State/Zip *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Desired School *
Current School *
Your answer
Current School City/State *
Your answer
Reason For Request *
Your answer
Special Programs *
Are there siblings requesting boundary exceptions? (a boundary form will need to be filled out for each child) *
If YES, list names, grades, and school of siblings: (a boundary form will need to be filled out for each child)
Your answer
Has the student been expelled or long-term suspended from any school or district? *
Is the student in the process of being expelled or long-term suspended from another school or district? *
Is the student currently being Supervised by a juvenile court? *
Providing false information on this form will result in the application being denied or admission being revoked. The parent/guardian signing this application affirms that the student seeking enrollment will abide by the rules , standards, and policies of the school and district if enrolled. Failure to comply with school and district rules could lead to revocation of the boundary variance. *
Application will be pending until decisions are made June 2017 prior to the new school year. Thank you for choosing FUSD!
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