Clinton City Schools Request for Out of District Acceptance
Email address *
REQUEST *
STUDENT'S FIRST NAME *
Your answer
STUDENT'S MIDDLE NAME *
Your answer
STUDENT'S LAST NAME *
Your answer
STUDENT'S ID
Your answer
ETHNICITY *
2019-2020 SCHOOL ENROLLMENT
Your answer
2019-2020 GRADE
PARENT/GUARDIAN(S) FIRST NAME
Your answer
PARENT/GUARDIAN(S) LAST NAME
Your answer
MAILING ADDRESS ( Address, City, State, Zipcode) *
Your answer
PARENT'S CELL PHONE NUMBER *
Your answer
PARENT'S OTHER CONTACT NUMBER
Your answer
PARENT'S WORK PHONE NUMBER
Your answer
RESIDENCE ADDRESS (IF DIFFERENT FROM ABOVE)
Your answer
GRADE (2020-2021 SCHOOL YEAR) *
SCHOOL DESIRED (2020-2021 SCHOOL YEAR) *
IN WHAT SCHOOL DISTRICT DO YOU RESIDE? *
Your answer
WHAT IS YOUR REASON FOR THIS REQUEST? *
Your answer
IS STUDENT IN GOOD STANDING (ACADEMICALLY, ATTENDANCE AND/OR DISCIPLINE)? *
IF NO TO ABOVE QUESTION, PLEASE EXPLAIN.
Your answer
HAS THE STUDENT EVER BEEN SUSPENDED OR EXPELLED? *
IF YES TO THE ABOVE QUESTION, PLEASE EXPLAIN.
Your answer
DOES THE STUDENT HAVE A CURRENT IEP FOR SPECIAL EDUCATION SERVICES? *
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