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Interdistrict Open Enrollment Application
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* Indicates required question
District of Residence
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Student First Name
*
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Student Middle Name(s)
*
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Student Last Name
*
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Student Address
*
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Student Date of Birth
*
MM
/
DD
/
YYYY
Parent/Guardian #1 Name
*
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Parent/Guardian #1 Address
*
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Parent/Guardian #1 Telephone
*
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Parent/Guardian #1 Email
*
This email address will receive follow-up information, updates and other details.
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Parent/Guardian #2 Name:
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Parent/Guardian #2 Address:
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Parent/Guardian #2 Telephone:
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Parent/Guardian #2 Email:
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Western Brown School to Attend
*
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Grade Level of Student in 2025-2026
*
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Does Student Have IEP
*
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If yes, Explain
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If student will be in grades 9-12, list all courses requested for 2025-2026 School Year.
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Parent Signature
*
Type first name, last name. By providing an electronic signature, parent/guardian give permission for their student to attend, should they be accepted.
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Applications must be received in the Superintendent's office not later than May 26, 2025. Applications will be acted upon not later than July 1, 2025.
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If applying after deadline, please state reason(s).
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