Out of District Enrollment Form for 21-22
Email address *
1. List all students' Name (Last, First, Middle) *
List ALL students' that you have applying to attend Bardstown City Schools
2. List all students' birthday *
List the birthday for all students - mm/dd/year
3. List the status of all students *
Required
4. The student(s) will be in which grade(s) for the 21-22 year? *
Required
5. In which Nelson County School is your child(ren) currently enrolled? *
Please select the school or select "Not currently coming from the Nelson County School District"
Required
6. Does this student(s) have an Individual Education Plan (IEP)? *
7. Does this student have a 504 Plan? *
8. Does this student receive any special services while at school? *
If yes, please briefly describe which student and what service the student receives.
9. Has the student(s) ever been suspended or had other behavior issues in school? *
If yes, please briefly describe below.
10. Has this student(s) had any issues with regular school attendance? *
If yes, please briefly describe below.
11. Please briefly describe the students' academic performance in school? *
12. Please briefly explain the reason(s) for your out-of-district request below. *
13. Students' Primary Address *
The full address where the student is living, including zip code.
14. Parent/Guardian Name (Last, First, Middle) *
I declare that I am the parent or legal guardian of student applying
15. Parent/Guardian Primary Phone Number *
16. Parent/Guardian email address *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Bardstown City Schools. Report Abuse