Open Enrollment Application 17-18
Millcreek-West Unity Local School District
Application Date: *
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First Name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Race *
Your answer
Gender *
Parent Name or Guardian *
Your answer
Mailing Address *
Street and/or Post Office Box and City, State, & Zip Code
Your answer
Email Address
Your answer
Phone Number *
Your answer
Home District *
Your answer
Date of Birth *
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Gr. for 17-18 *
Explain Reason for Transfer *
Your answer
Has your child been suspended/expelled from ANY school district for ten consecutive days or more? *
Does your child require Special Programs? *
No student shall be denied admission to the Millcreek-West Unity Local School District or to a particular course or instructional program or otherwise discriminated against for reasons of race, color, national origin, sex, handicap, or any other basis of unlawful discrimination.
Parent/Guardian Signature: *
Type your name here to acknowledge the above information is correct.
Your answer
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