OUT-OF-DISTRICT CHOICE TRANSFER FORM
Students living in Vancouver School District who wish to attend a school in another school district should use this form to request a transfer to a school out side of our district.
This form is for residents of Vancouver Public Schools only. If you are a resident of another school district wishing to attend Vancouver Public Schools, please contact the school district you reside in to start the boundary process.
Is this an initial request or a renewal?
Clear selection
Student's Resident School: choose the school your student would normally attend based on your physical address *
Requested School District: choose the school district that the school you are requesting for your student to attend is located in *
Required
Requested School: List the school you are requesting for your student to attend *
School Currently Enrolled or Last Attended *
Student's Last Name *
Student's Middle Name
Student's First Name *
Date of Birth *
MM
/
DD
/
YYYY
Address *
Zip Code *
Phone Number *
Secondary Phone Number
Email Address (An email address is required in order to process this form) *
Is your student currently being tested for or participating in one of the following programs? *
Yes
No
IEP
Gifted
504
Bilingual (ELL)
Title 1/LAP
What grade will your student be attending next year?
Reason for request (Please choose only one) *
Please provide any additional information as to why this request for transfer is being made.
Student Behavior Information
Yes
No
Does the student have a record of conviction of crimes, violent or disruptive behavior or gang membership?
Has this student been expelled or suspended for more than 10 consecutive days?
Has the student repeatedly failed to comply with requirements for participation in an online school program, such as participating in weekly direct contact with the teacher or monthly progress evaluations?
Has the student and/or parent had any formal meetings with school officials regarding school attendance issues in the past two years?
Is this student under a court order to attend school or is a truancy petition in the process of being filed?
Clear selection
Notices
• The transfer request is not complete until the resident school district has submitted the request to the nonresident school district, and it has been accepted. The student remains the responsibility of the resident school district until the effective start date at the nonresident school.
• The parent/guardian will be notified by email (or postal mail if an email is not provided) of acceptance and the effective start date or rejection.
• If the request is rejected, the notification will include the reason for the denial and steps to appeal the decision.
• If a district does not respond to a request within 45 days of the request, the request is treated as a denial and the parent/guardian can appeal.
• Under the Choice law, the nonresident school district becomes responsible for all matters related to the education of the student (basic education, special education, home/hospital services, truancy, CEDARS reporting, administration of state educational assessments, etc.). Legal Reference: RCW 28A.225.220 through 230.
Please Check Yes if you read the information above. *
Required
Acknowledgements
• I certify that the information provided is accurate and complete.
• I understand that approval of this request shall be dependent upon the acceptance and rejection standards stated in the nonresident school district’s policy, and rescindment (revoking) of this transfer may occur in accordance to the conditions listed in the nonresident school district’s policy.
• I understand that my student must continue to attend the resident school until the effective start date of the transfer and that nonattendance is subject to truancy procedures.
• I understand that I will be responsible for providing transportation to and from school for my student, unless the nonresident district is required to provide transportation for the student with a disability under Section 504 of the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act (IDEA).
• I understand that requests are approved for one school year only, and it is my responsibility to complete a new form each year.
• I understand that should my student move and no longer be a resident of the district, the transfer expires and I must submit a new request to the new resident school district.
• FERPA Release: I authorize the resident school district to release any and all of my student’s educational records to the Choice Coordinator of the nonresident school district. By my signature, I acknowledge that although I am not required to release my student’s records, I am giving my consent to release information. This release will remain in effect while my student is enrolled.
• This request to attend nonresident school district shall be dependent upon criteria for acceptance of nonresident district students established by the nonresident school district. In addition, the nonresident district reserves the right to revoke this transfer at any time throughout the school year if:
-student does not follow the rules and regulations applicable to all students attending in the nonresident district,
-it becomes necessary to change the education program/setting/placement of the student, and there is not room in the
program to which the student would need to change,
-information provided by the applicant has been misrepresented,
-parent’s full-time certificated or classified employment with the district ends, or
-nonresident student’s placement displaces a resident student or if space in the grade level classes or programs becomes
unavailable.

• When any of the above reasons occur, the transfer approval becomes null and void. Any further consideration for readmission must be based on completion of a new application.
Please Check Yes if you read the information above. *
Required
Electronic Signature
In providing your electronic signature below, you verify that all information contained in this declaration to be accurate and in accordance with RCW 28A.225.225.
Full Name of Parent/Legal Guardian *
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