Completion of this form is required of each applicant for a transfer in order to apply the criteria of this policy. Failure to fully and truthfully complete and timely submit this form to the district will result in a denial of the transfer. Completion of this form will be in addition to completion of any form required by the State Board of Education. Full name of student as it appears on the student’s birth certificate: Date of student’s birth: Current address of student: Full names of parent(s), guardian(s), or custodian(s) of the student: Educational history of the student: A. School district in student currently resides: B. School in which the student is currently enrolled, if different from above. C. If the student has not exclusively attended the school district in which the student is currently enrolled, list the name of each school district and addresses, if known, in which student has ever been enrolled: School: Dates of Attendance: Grade Completed Upon Leaving District: School: Dates of Attendance: Grade Completed Upon Leaving District: School: Dates of Attendance: Grade Completed Upon Leaving District: Current or last completed grade of student: Grade in which the student desires to enroll:
Completion of this form is required of each applicant for a transfer in order to apply the criteria of this policy. Failure to fully and truthfully complete and timely submit this form to the district will result in a denial of the transfer. Completion of this form will be in addition to completion of any form required by the State Board of Education. Full name of student as it appears on the student’s birth certificate: Date of student’s birth: Current address of student: Full names of parent(s), guardian(s), or custodian(s) of the student: Educational history of the student: A. School district in student currently resides: B. School in which the student is currently enrolled, if different from above. C. If the student has not exclusively attended the school district in which the student is currently enrolled, list the name of each school district and addresses, if known, in which student has ever been enrolled: School: Dates of Attendance: Grade Completed Upon Leaving District: School: Dates of Attendance: Grade Completed Upon Leaving District: School: Dates of Attendance: Grade Completed Upon Leaving District: Current or last completed grade of student: Grade in which the student desires to enroll:
Appendix%2009-11-17.docx