Out-of-District Request Form
Please fill out this form if you would like to apply for out-of-district enrollment.
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Student Last Name, First Name & Middle Initial *
Grade Student Will Enter *
Please list any additional students you would like for us to consider. Please include last name, first name and grade. *
Is this a request for renewal of out-of-district enrollment? *
Students Home Address - Please include City, St and Zip *
Mother/Guardian Name (Last, First) *
Mother/Guardian Cell Phone *
Mother/Guardian Email Address *
Father/Guardian Name (Last, First) *
Father/Guardian Cell Phone # *
Father/Guardian Email Address *
Please list all schools attended and # of years attending *
Reason for Transfer *
Did your child miss more than 10 days of school during the last school year? *
If your child missed more than 10 days of school please explain why - *
Has your child received In-School Suspension, Out of School Suspension, or had a past history of behavioral concerns (detentions, numerous parent meetings, etc) in the past 4 years? *
If yes please explain: *
Has you child, during the last school year, had any problem getting homework in on time? *
What school year would you like to enroll your student in? *
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