NREVSD Open Enrollment Application
2019/2020
Email address *
Student First Name: *
Your answer
Student Last Name: *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian First Name: *
Your answer
Parent/Guardian Last Name: *
Your answer
Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zipcode: *
Your answer
Phone Number: *
Your answer
District of Residence: *
Are you currently employed by the New Richmond Exempted Village School District? *
Was your open enrollment application approved last year? *
School building most recently attended: *
Your answer
School Building Requested: *
Elementary School Building Second Choice
Grade level for student 2018/2019? *
Grade level for student 2019/2020? *
Is student enrolled in any special education or tutorial programs? If yes, describe:
Your answer
Has your student been suspended or expelled during the previous or current school year? *
If your student was suspended or expelled in the previous school year, please describe.
Your answer
Please list any grade 1-5 siblings that are open enrollment applicants at New Richmond Exempted Village School District.
Your answer
Parent/Guardian's Signature: (Signature permits NREVSD to access your student's records.) *
Required
A copy of your responses will be emailed to the address you provided.
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