Application for Change in School Assignment
Form to be used by resident students requesting assignment to a District school outside their attendance area/zone.
Email address *
ONE APPLICATION PER CHILD
Student's Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Present Grade *
Address *
Your answer
Name of Parent/Guardian *
Your answer
Phone # *
Your answer
Resident School (School serving my attendance area for the 2019-2020 school year) *
Present School Attending *
School Requested *
For School Year *
Grade Entering *
Date of Request *
MM
/
DD
/
YYYY
Reason for the Request (If you are a school/district employee please state so in reason.) *
Your answer
I understand that, if approved:
This change in assignment will be granted for only one (1) school year and that I assume responsibility for my child's transportation.

The District has the right to revoke the waiver for the remainder of the school year due to attendance problems or any infraction deemed a disruption to the educational process.

I understand that if the child has more than 3 unexcused absences/tardies or has behavior problems, the waiver will not be considered for the upcoming year.

I understand that my child may be required to re-enroll in the school serving my attendance area should enrollment in the requested school exceed class "cap" sizes.

Parent/Guardian's Signature *
Your answer
Consideration will be given to the circumstances prompting this request and the date the request is received by the Director of Pupil Personnel.
Approval contingent upon availability of space.
A copy of your responses will be emailed to the address you provided.
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