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Provisional School Choice Request Form
The following procedures will be utilized in administering the Board of Education policy JC in specific circumstances of a student moving during the school year.

1. Students who move within the district after the first day of school attendance must first provide the school office with new proof of residency and then may fill out a provisional choice form requesting to remain at the school for the remainder of the year.

2. All students requesting provisional school choice must complete this provisional choice form and click on "submit" to send it to the office of the Assistant Superintendent.

3. Provisional school choice may be granted for the remainder of the school year. Parents wanting their children to remain at a school outside their attendance area after provisional choice has expired will need to apply for school choice during the application period.

4. The provisional school choice student must demonstrate acceptable behavior, regular and prompt attendance and acceptable academic progress toward graduation. Failure to comply with any of the above may result in the student being moved to the home school.

5. Parent/Guardian must agree to provide transportation to the school outside the home attendance area.

6. The superintendent or superintendent’s designee may act on the applications based upon the merits of the application or may refer the matter to the Board of Education.

Student Name *
Your answer
Date of Birth *
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Street Address *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
School Currently Attending *
Your answer
Current Grade *
Your answer
New Home School *
Your answer
Date of Move *
Your answer
Reason for Provisional School Choice Request: *
Your answer
By checking the box below I acknowledge that I have read the above procedures and understand that if approved, this approval will expire at the end of the current school year. *
Required
Parent Name *
Your answer
Date *
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DD
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YYYY
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